Monika Kozieł1,2, Michał Mazurek2, Christine Teutsch3, Hans-Christoph Diener4, Sergio J Dubner5, Jonathan L Halperin6, Chang-Sheng Ma7, Kenneth J Rothman8, Axel Brandes9, Miney Paquette10, Kristina Zint11, Lionel Riou França11,12, Shihai Lu13, Dorothee B Bartels11,14, Menno V Huisman15, Gregory Y H Lip1,2,16. 1. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK. 2. 1st Department of Cardiology and Angiology, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland. 3. Department of Clinical Development and Medical Affairs, Therapeutic Area Cardiometabolism, Boehringer Ingelheim International GmbH, 55216 Ingelheim am Rhein, Germany. 4. Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, 45133 Essen, Germany. 5. Clínica y Maternidad Suizo Argentina, Buenos Aires C1420, Argentina. 6. Icahn School of Medicine at Mount Sinai, New York, NY 10001, USA. 7. Cardiology Department, Atrial Fibrillation Center, Beijing AnZhen Hospital, Capital Medical University, Beijing 100011, China. 8. RTI Health Solutions, Research Triangle Park, NC 27709, USA. 9. Department of Cardiology, Odense University Hospital, 5000 Odense, Denmark. 10. Department of Medicine, Boehringer Ingelheim, Burlington, ON 05401, Canada. 11. Global Epidemiology Department, Boehringer Ingelheim International GmbH, 55216 Ingelheim am Rhein, Germany. 12. Sanofi-Aventis Recherche et Development, 91380 Chilly-Mazarin, France. 13. Biostatistics and Data Sciences Department, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT 06877, USA. 14. Hannover Medical School, 30159 Hannover, Germany. 15. Department of Thrombosis and Hemostasis, Leiden University Medical Center, 1043 AJ Leiden, The Netherlands. 16. Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.
Abstract
BACKGROUND: We aimed to assess the extent to which drug persistence is better with non-vitamin K antagonist oral anticoagulants (NOACs) than vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients and to estimate the difference in therapy persistence depending on NOAC dosing regimen (once daily (QD) vs. twice daily (BID)). METHODS: Consecutive patients were followed for 1 year in phase III of the GLORIA-AF registry. Drug persistence was defined as the use of OAC without any discontinuation in >30 days or switching to alternative therapy. RESULTS: Among 21,109 eligible patients in phase III, 17,266 patients who were prescribed OAC at baseline and those who took ≥1 OAC dose were included. The 1-year proportion of patients receiving NOAC and VKA who persisted on treatment was 80% and 75%, respectively. The 1-year persistence with NOACs BID and NOACs QD was 81% and 80%, respectively. Female gender, hypertension, older age, alcohol use, permanent, asymptomatic, and minimally symptomatic AF were associated with better OAC persistence. Region, medication usage predisposing to bleeding, being a current smoker, treatment reimbursement, and proton pump inhibitors were associated with lower OAC persistence. CONCLUSIONS: Drug persistence was higher with NOACs (1-year persistence was 80%) than with VKAs (75%). There was little difference in 1-year persistence between NOAC dosing regimens.
BACKGROUND: We aimed to assess the extent to which drug persistence is better with non-vitamin K antagonist oral anticoagulants (NOACs) than vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients and to estimate the difference in therapy persistence depending on NOAC dosing regimen (once daily (QD) vs. twice daily (BID)). METHODS: Consecutive patients were followed for 1 year in phase III of the GLORIA-AF registry. Drug persistence was defined as the use of OAC without any discontinuation in >30 days or switching to alternative therapy. RESULTS: Among 21,109 eligible patients in phase III, 17,266 patients who were prescribed OAC at baseline and those who took ≥1 OAC dose were included. The 1-year proportion of patients receiving NOAC and VKA who persisted on treatment was 80% and 75%, respectively. The 1-year persistence with NOACs BID and NOACs QD was 81% and 80%, respectively. Female gender, hypertension, older age, alcohol use, permanent, asymptomatic, and minimally symptomatic AF were associated with better OAC persistence. Region, medication usage predisposing to bleeding, being a current smoker, treatment reimbursement, and proton pump inhibitors were associated with lower OAC persistence. CONCLUSIONS: Drug persistence was higher with NOACs (1-year persistence was 80%) than with VKAs (75%). There was little difference in 1-year persistence between NOAC dosing regimens.
Entities:
Keywords:
GLORIA-AF; atrial fibrillation; dosing frequency; non-vitamin K antagonist oral anticoagulants; oral anticoagulants; vitamin K antagonists
Authors: Elisabeth Smits; Felicita Andreotti; Eline Houben; Harry J G M Crijns; Sylvia Haas; George Spentzouris; Tania Schink; Rosa Gini; Claudia Bartolini; Fernie Penning-van Beest; Ron Herings Journal: Drugs Real World Outcomes Date: 2022-01-06