Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis
Abstract Background African Americans are under-represented in trials evaluating oral anticoagulants for the treatment of acute venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban versus warfarin for the treatment of VTE in African American...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | Thrombosis Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12959-020-00219-w |
| _version_ | 1819147588464541696 |
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| author | Olivia S. Costa Stanley Thompson Veronica Ashton Michael Palladino Thomas J. Bunz Craig I. Coleman |
| author_facet | Olivia S. Costa Stanley Thompson Veronica Ashton Michael Palladino Thomas J. Bunz Craig I. Coleman |
| author_sort | Olivia S. Costa |
| collection | DOAJ |
| description | Abstract Background African Americans are under-represented in trials evaluating oral anticoagulants for the treatment of acute venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban versus warfarin for the treatment of VTE in African Americans. Methods We utilized Optum® De-Identified Electronic Health Record data from 11/1/2012–9/30/2018. We included African Americans experiencing an acute VTE during a hospital or emergency department visit, who received rivaroxaban or warfarin as their first oral anticoagulant within 7-days of the acute VTE event and had ≥1 provider visit in the prior 12-months. Differences in baseline characteristics between cohorts were adjusted using inverse probability-of-treatment weighting based on propensity scores (standard differences < 0.10 were achieved for all covariates). Our primary endpoint was the composite of recurrent VTE or major bleeding at 6-months. Three- and 12-month timepoints were also assessed. Secondary endpoints included recurrent VTE and major bleeding as individual endpoints. Cohort risk was compared using Cox regression and reported as hazard ratios (HRs) with 95% confidence intervals (CIs). Results We identified 2097 rivaroxaban and 2842 warfarin users with incident VTE. At 6-months, no significant differences in the composite endpoint (HR = 0.96, 95%CI = 0.75–1.24), recurrent VTE (HR = 1.02, 95%CI = 0.76–1.36) or major bleeding alone (HR = 0.93, 95%CI = 0.59–1.47) were observed between cohorts. Analysis at 3- and 12-months provided consistent findings for these endpoints. Conclusions In African Americans experiencing an acute VTE, no significant difference in the incidence of recurrent VTE or major bleeding was observed between patients receiving rivaroxaban or warfarin. |
| first_indexed | 2024-12-22T13:32:12Z |
| format | Article |
| id | doaj.art-e51d1e5c7f5d4f8bbe36ce907d2c77f3 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-22T13:32:12Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-e51d1e5c7f5d4f8bbe36ce907d2c77f32022-12-21T18:24:09ZengBMCThrombosis Journal1477-95602020-04-011811910.1186/s12959-020-00219-wRivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysisOlivia S. Costa0Stanley Thompson1Veronica Ashton2Michael Palladino3Thomas J. Bunz4Craig I. Coleman5Department of Pharmacy Practice, University of Connecticut School of PharmacyTeamHealth LifePoint GroupReal World Value and Evidence, Janssen Scientific Affairs LLCMedical Affairs, Janssen Pharmaceuticals Inc.Department of Pharmacoepidemiology, New England Health Analytics LLCDepartment of Pharmacy Practice, University of Connecticut School of PharmacyAbstract Background African Americans are under-represented in trials evaluating oral anticoagulants for the treatment of acute venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban versus warfarin for the treatment of VTE in African Americans. Methods We utilized Optum® De-Identified Electronic Health Record data from 11/1/2012–9/30/2018. We included African Americans experiencing an acute VTE during a hospital or emergency department visit, who received rivaroxaban or warfarin as their first oral anticoagulant within 7-days of the acute VTE event and had ≥1 provider visit in the prior 12-months. Differences in baseline characteristics between cohorts were adjusted using inverse probability-of-treatment weighting based on propensity scores (standard differences < 0.10 were achieved for all covariates). Our primary endpoint was the composite of recurrent VTE or major bleeding at 6-months. Three- and 12-month timepoints were also assessed. Secondary endpoints included recurrent VTE and major bleeding as individual endpoints. Cohort risk was compared using Cox regression and reported as hazard ratios (HRs) with 95% confidence intervals (CIs). Results We identified 2097 rivaroxaban and 2842 warfarin users with incident VTE. At 6-months, no significant differences in the composite endpoint (HR = 0.96, 95%CI = 0.75–1.24), recurrent VTE (HR = 1.02, 95%CI = 0.76–1.36) or major bleeding alone (HR = 0.93, 95%CI = 0.59–1.47) were observed between cohorts. Analysis at 3- and 12-months provided consistent findings for these endpoints. Conclusions In African Americans experiencing an acute VTE, no significant difference in the incidence of recurrent VTE or major bleeding was observed between patients receiving rivaroxaban or warfarin.http://link.springer.com/article/10.1186/s12959-020-00219-wAfrican AmericansAnticoagulantsRivaroxabanVenous thromboembolismWarfarin |
| spellingShingle | Olivia S. Costa Stanley Thompson Veronica Ashton Michael Palladino Thomas J. Bunz Craig I. Coleman Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis Thrombosis Journal African Americans Anticoagulants Rivaroxaban Venous thromboembolism Warfarin |
| title | Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis |
| title_full | Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis |
| title_fullStr | Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis |
| title_full_unstemmed | Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis |
| title_short | Rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in African American patients: a retrospective cohort analysis |
| title_sort | rivaroxaban versus warfarin for treatment and prevention of recurrence of venous thromboembolism in african american patients a retrospective cohort analysis |
| topic | African Americans Anticoagulants Rivaroxaban Venous thromboembolism Warfarin |
| url | http://link.springer.com/article/10.1186/s12959-020-00219-w |
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