Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study
Background: Non-vitamin K antagonist oral anticoagulants (NOACs) show a favorable balance between efficacy and safety compared with warfarin for patients with non-valvular atrial fibrillation (NVAF). In “real-world” practice, however, NOAC adherence and persistence among patients are not clear. The...
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| Format: | Article |
| Language: | English |
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Wiley
2015-12-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1880427615000575 |
| _version_ | 1818788380107866112 |
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| author | Tsuyoshi Shiga, MD Miyoko Naganuma, BSc Takehiko Nagao, MD Kenji Maruyama, MD Atsushi Suzuki, MD Kagari Murasaki, MD Nobuhisa Hagiwara, MD |
| author_facet | Tsuyoshi Shiga, MD Miyoko Naganuma, BSc Takehiko Nagao, MD Kenji Maruyama, MD Atsushi Suzuki, MD Kagari Murasaki, MD Nobuhisa Hagiwara, MD |
| author_sort | Tsuyoshi Shiga, MD |
| collection | DOAJ |
| description | Background: Non-vitamin K antagonist oral anticoagulants (NOACs) show a favorable balance between efficacy and safety compared with warfarin for patients with non-valvular atrial fibrillation (NVAF). In “real-world” practice, however, NOAC adherence and persistence among patients are not clear. The aim of this study is to evaluate NOAC and warfarin persistence in Japanese patients with NVAF who newly started these drugs.
Methods: We retrospectively studied 401 patients with NVAF who had newly started NOACs during the first 18 months after our hospital adopted their use (197 dabigatran, 107 rivaroxaban, 102 apixaban) and 200 patients with NVAF who had newly started warfarin during the same period. The endpoint was drug discontinuation for each drug.
Results: During the follow-up period (up to a maximum of 24 months), 113 (28%) patients who had newly started NOACs and 33 (17%) patients who had newly started warfarin discontinued the drug. The persistence rates of patients prescribed NOACs was lower than that of patients prescribed warfarin at 3, 6, and 12 months (85% versus 93%, 79% versus 88%, and 70% versus 82%, respectively). One-tenth of patients who had newly started NOACs discontinued the drug by their own decision. Drug adverse events, worsening renal dysfunction, and patient desire were the major causes of NOAC discontinuation.
Conclusions: The rate of persistence of prescribed NOACs was significantly lower than that of warfarin in Japanese patients with NVAF. |
| first_indexed | 2024-12-18T14:22:45Z |
| format | Article |
| id | doaj.art-b48efc27dbd244f698ba09a3acf07830 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 |
| language | English |
| last_indexed | 2024-12-18T14:22:45Z |
| publishDate | 2015-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-b48efc27dbd244f698ba09a3acf078302022-12-21T21:04:48ZengWileyJournal of Arrhythmia1880-42762015-12-0131633934410.1016/j.joa.2015.04.004Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational studyTsuyoshi Shiga, MD0Miyoko Naganuma, BSc1Takehiko Nagao, MD2Kenji Maruyama, MD3Atsushi Suzuki, MD4Kagari Murasaki, MD5Nobuhisa Hagiwara, MD6Department of Cardiology, Tokyo Women’s Medical University, Tokyo, JapanIntelligent Clinical Research and Innovation Center, Tokyo Women’s Medical University Hospital, Tokyo, JapanDepartment of Neurology, Tokyo Women’s Medical University, Tokyo, JapanDepartment of Neurology, Tokyo Women’s Medical University, Tokyo, JapanDepartment of Cardiology, Tokyo Women’s Medical University, Tokyo, JapanDepartment of Cardiology, Tokyo Women’s Medical University, Tokyo, JapanDepartment of Cardiology, Tokyo Women’s Medical University, Tokyo, JapanBackground: Non-vitamin K antagonist oral anticoagulants (NOACs) show a favorable balance between efficacy and safety compared with warfarin for patients with non-valvular atrial fibrillation (NVAF). In “real-world” practice, however, NOAC adherence and persistence among patients are not clear. The aim of this study is to evaluate NOAC and warfarin persistence in Japanese patients with NVAF who newly started these drugs. Methods: We retrospectively studied 401 patients with NVAF who had newly started NOACs during the first 18 months after our hospital adopted their use (197 dabigatran, 107 rivaroxaban, 102 apixaban) and 200 patients with NVAF who had newly started warfarin during the same period. The endpoint was drug discontinuation for each drug. Results: During the follow-up period (up to a maximum of 24 months), 113 (28%) patients who had newly started NOACs and 33 (17%) patients who had newly started warfarin discontinued the drug. The persistence rates of patients prescribed NOACs was lower than that of patients prescribed warfarin at 3, 6, and 12 months (85% versus 93%, 79% versus 88%, and 70% versus 82%, respectively). One-tenth of patients who had newly started NOACs discontinued the drug by their own decision. Drug adverse events, worsening renal dysfunction, and patient desire were the major causes of NOAC discontinuation. Conclusions: The rate of persistence of prescribed NOACs was significantly lower than that of warfarin in Japanese patients with NVAF.http://www.sciencedirect.com/science/article/pii/S1880427615000575AdherenceAtrial fibrillationJapaneseNon-vitamin K antagonist oral anticoagulantsWarfarin |
| spellingShingle | Tsuyoshi Shiga, MD Miyoko Naganuma, BSc Takehiko Nagao, MD Kenji Maruyama, MD Atsushi Suzuki, MD Kagari Murasaki, MD Nobuhisa Hagiwara, MD Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study Journal of Arrhythmia Adherence Atrial fibrillation Japanese Non-vitamin K antagonist oral anticoagulants Warfarin |
| title | Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study |
| title_full | Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study |
| title_fullStr | Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study |
| title_full_unstemmed | Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study |
| title_short | Persistence of non-vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single-center observational study |
| title_sort | persistence of non vitamin k antagonist oral anticoagulant use in japanese patients with atrial fibrillation a single center observational study |
| topic | Adherence Atrial fibrillation Japanese Non-vitamin K antagonist oral anticoagulants Warfarin |
| url | http://www.sciencedirect.com/science/article/pii/S1880427615000575 |
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