Between 2012 and 2017, warfarin prescriptions for VTE plummeted from 98.7% to 17.5%, while rivaroxaban and apixaban use increased to 42.7% and 38.6%, respectively.
Observational (n=137,203)
Yes
What are the temporal trends in the prescription of direct oral anticoagulants versus warfarin for the primary treatment of VTE in the US from 2012 to 2017?
Rivaroxaban and apixaban have largely replaced warfarin for the primary treatment of VTE in the United States between 2012 and 2017.
BACKGROUND: Direct oral anticoagulants (DOACs), namely rivaroxaban, apixaban, dabigatran, and edoxaban, are now included together with warfarin as standards of care for the primary treatment of venous thromboembolism (VTE). The extent to which the DOACs have been adopted since receiving US Food and Drug Administration (FDA) approval is unknown. OBJECTIVE: To document temporal trends in oral anticoagulant (OAC) prescriptions among anticoagulant-naïve patients initiating OACs for VTE primary treatment in the United States and to report participant characteristics by OAC prescribed for the year 2017. METHODS: codes and prescriptions for OACs via outpatient pharmaceutical claims data. RESULTS: The 137 203 VTE cases were on average (± standard deviation) 56.7 ± 16.0 years old and 49.9% female. Warfarin was prescribed to 98.7% of VTE patients receiving an OAC in quarter 1 (January through March) of 2012. By quarter 4 (October through December) of 2017, warfarin was prescribed to 17.5%, while rivaroxaban was prescribed to 42.7%, apixaban to 38.6%, dabigatran to 1.3%, and edoxaban to <0.1%. In 2017, the comorbidity burden was highest among patients prescribed warfarin, intermediate among patients prescribed apixaban, and lowest among patients prescribed rivaroxaban. CONCLUSIONS: Rivaroxaban and apixaban use to treat VTE has increased dramatically since receiving FDA approval, whereas warfarin use has plummeted. Dabigatran and edoxaban are infrequently prescribed. Given widespread usage of rivaroxaban and apixaban, there is a need for continued monitoring of the comparative effectiveness of these OAC therapies in real-world settings.
Lutsey et al. (Mon,) conducted a observational in Venous thromboembolism (VTE) (n=137,203). Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated on Temporal trends in oral anticoagulant prescriptions. Between 2012 and 2017, warfarin prescriptions for VTE plummeted from 98.7% to 17.5%, while rivaroxaban and apixaban use increased to 42.7% and 38.6%, respectively.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: