Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain

Aims: The aim is to evaluate a management program for direct oral anticoagulants (DOACs) in non-valvular atrial fibrillation (NVAF) patients according to their profiles, appropriateness of dosing, patterns of crossover, effectiveness and safety. This is an observational and longitudinal prospective...

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Autores: Rodilla, E, Orts-Martínez, MI, Sanz-Caballer, MA, Gimeno-Brosel, MT, Arilla-Morel, MJ, Navarro-Gonzalo, I, Castillo-Valero, I, Salvador-Mercader, I, Carral-Tatay, A
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2023
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositório:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16116
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/16116
Access Level:Acceso aberto
Palavra-chave:Direct oral anticoagulants (DOACs)
Non-valvular atrial fibrillation (NVAF)
Real-world experience
Outcomes
Drug use review
Medication adherence
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spelling Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from SpainRodilla, EOrts-Martínez, MISanz-Caballer, MAGimeno-Brosel, MTArilla-Morel, MJNavarro-Gonzalo, ICastillo-Valero, ISalvador-Mercader, ICarral-Tatay, ADirect oral anticoagulants (DOACs)Non-valvular atrial fibrillation (NVAF)Real-world experienceOutcomesDrug use reviewMedication adherenceAims: The aim is to evaluate a management program for direct oral anticoagulants (DOACs) in non-valvular atrial fibrillation (NVAF) patients according to their profiles, appropriateness of dosing, patterns of crossover, effectiveness and safety. This is an observational and longitudinal prospective study in a cohort of patients attended in daily clinical practice in a regional hospital in Spain with 3-year a follow-up plan for patients initiating dabigatran, rivaroxaban or apixaban between Jan/2012 and Dec/2016. Methods: We analyzed 490 episodes of treatment (apixaban 2.5, 9.4%; apixaban 5, 21.4%; dabi-gatran 75, 0.6%; dabigatran 110, 12.4%; dabigatran 150, 19.8%; rivaroxaban 15, 17.8% and rivaroxaban 20, 18.6%) in 445 patients. 13.6% of patients on dabigatran, 9.7% on rivaroxaban, and 3.9% on apixaban switched to other DOACs or changed dosing. Results: Apixaban was the most frequent DOAC switched to. The most frequent reasons for switching were toxicity (23.8%), bleeding (21.4%) and renal deterioration (16.7%). Inappropria-teness of dose was found in 23.8% of episodes. Rates of stroke/transient ischemic attack (TIA) were 1.64/0.54 events/100 patients-years, while rates of major, clinically relevant non-major (CRNM) bleeding and intracranial bleeding were 2.4, 5, and 0.5 events/100 patients-years. Gas-trointestinal and genitourinary bleeding were the most common type of bleeding events (BE). On multivariable analysis, prior stroke and age were independent predictors of stroke/TIA. Concurrent platelet inhibitors, male gender and age were independent predictors of BE. Conclusion: This study complements the scant data available on the use of DOACs in NVAF patients in Spain, confirming a good safety and effectiveness profile. & COPY; 2023 The Authors. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).EDICIONES DOYMA S A2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16116REVISTA CLINICA ESPANOLAISSN: 00142565ISSNe: 15781860reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Españolinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p161162026-06-11T12:45:17Z
dc.title.none.fl_str_mv Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
title Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
spellingShingle Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
Rodilla, E
Direct oral anticoagulants (DOACs)
Non-valvular atrial fibrillation (NVAF)
Real-world experience
Outcomes
Drug use review
Medication adherence
title_short Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
title_full Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
title_fullStr Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
title_full_unstemmed Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
title_sort Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain
dc.creator.none.fl_str_mv Rodilla, E
Orts-Martínez, MI
Sanz-Caballer, MA
Gimeno-Brosel, MT
Arilla-Morel, MJ
Navarro-Gonzalo, I
Castillo-Valero, I
Salvador-Mercader, I
Carral-Tatay, A
author Rodilla, E
author_facet Rodilla, E
Orts-Martínez, MI
Sanz-Caballer, MA
Gimeno-Brosel, MT
Arilla-Morel, MJ
Navarro-Gonzalo, I
Castillo-Valero, I
Salvador-Mercader, I
Carral-Tatay, A
author_role author
author2 Orts-Martínez, MI
Sanz-Caballer, MA
Gimeno-Brosel, MT
Arilla-Morel, MJ
Navarro-Gonzalo, I
Castillo-Valero, I
Salvador-Mercader, I
Carral-Tatay, A
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Direct oral anticoagulants (DOACs)
Non-valvular atrial fibrillation (NVAF)
Real-world experience
Outcomes
Drug use review
Medication adherence
topic Direct oral anticoagulants (DOACs)
Non-valvular atrial fibrillation (NVAF)
Real-world experience
Outcomes
Drug use review
Medication adherence
description Aims: The aim is to evaluate a management program for direct oral anticoagulants (DOACs) in non-valvular atrial fibrillation (NVAF) patients according to their profiles, appropriateness of dosing, patterns of crossover, effectiveness and safety. This is an observational and longitudinal prospective study in a cohort of patients attended in daily clinical practice in a regional hospital in Spain with 3-year a follow-up plan for patients initiating dabigatran, rivaroxaban or apixaban between Jan/2012 and Dec/2016. Methods: We analyzed 490 episodes of treatment (apixaban 2.5, 9.4%; apixaban 5, 21.4%; dabi-gatran 75, 0.6%; dabigatran 110, 12.4%; dabigatran 150, 19.8%; rivaroxaban 15, 17.8% and rivaroxaban 20, 18.6%) in 445 patients. 13.6% of patients on dabigatran, 9.7% on rivaroxaban, and 3.9% on apixaban switched to other DOACs or changed dosing. Results: Apixaban was the most frequent DOAC switched to. The most frequent reasons for switching were toxicity (23.8%), bleeding (21.4%) and renal deterioration (16.7%). Inappropria-teness of dose was found in 23.8% of episodes. Rates of stroke/transient ischemic attack (TIA) were 1.64/0.54 events/100 patients-years, while rates of major, clinically relevant non-major (CRNM) bleeding and intracranial bleeding were 2.4, 5, and 0.5 events/100 patients-years. Gas-trointestinal and genitourinary bleeding were the most common type of bleeding events (BE). On multivariable analysis, prior stroke and age were independent predictors of stroke/TIA. Concurrent platelet inhibitors, male gender and age were independent predictors of BE. Conclusion: This study complements the scant data available on the use of DOACs in NVAF patients in Spain, confirming a good safety and effectiveness profile. & COPY; 2023 The Authors. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16116
url https://fisabio.portalinvestigacion.com/publicaciones/16116
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv EDICIONES DOYMA S A
publisher.none.fl_str_mv EDICIONES DOYMA S A
dc.source.none.fl_str_mv REVISTA CLINICA ESPANOLA
ISSN: 00142565
ISSNe: 15781860
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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