Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS-ACTS Substudy.
Craig I Coleman,Sylvia Haas,Alexander G.G. Turpie,Silvia Kuhls,Susanne Hess,Thomas Evers,Pierre Amarenco,Paulus Kirchhof,Paulus Kirchhof,A. John Camm,Xantus Investigators +10 more
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TLDR
The efficacy, safety, and ease of use of rivaroxaban may reduce anticoagulation‐treatment burden and improve nonvalvular atrial fibrillation (NVAF) patient satisfaction compared with vitamin K antagonists (VKAs).Abstract:
Background
The efficacy, safety, and ease of use of rivaroxaban may reduce anticoagulation-treatment burden and improve nonvalvular atrial fibrillation (NVAF) patient satisfaction compared with vitamin K antagonists (VKAs).
Hypothesis
Transitioning from a VKA to rivaroxaban improves treatment satisfaction in routine practice.
Methods
Xarelto for Prevention of Stroke in Patients With Atrial Fibrillation (XANTUS) is a prospective, noninterventional study in patients with NVAF prescribed rivaroxaban for prevention of stroke in routine practice. Patients receiving a VKA 4 weeks prior to the initial XANTUS study visit and switched to rivaroxaban were asked to complete the Anti-Clot Treatment Scale (ACTS). Changes from the initial visit to the first follow-up visit at ∼ 3 months (corresponding to a comparison of rivaroxaban vs prior VKA) for ACTS burden and benefit scores were calculated using and reported as least squared mean differences (LSMDs) with 95% confidence intervals (CIs).
Results
The study included 1291 NVAF patients with prior VKA treatment. The mean baseline ACTS burden and benefit scores were 50.51 ± 8.42 and 10.30 ± 2.70, respectively. After ∼ 3 months of rivaroxaban treatment, LSMDs were 4.38 points (95% CI: 2.53-6.22, P < 0.0001) for the burden and 1.01 points (95% CI: 0.27-1.75, P = 0.0075) for the benefit score. Fifty-four percent and 48% of patients reported experiencing at least a minimally important clinical difference in burden and benefit scores, respectively.
Conclusions
Within this XANTUS cohort, switching from a VKA to rivaroxaban yielded statistically and clinically significant improvements in ACT burden and benefit scores.read more
Citations
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Journal ArticleDOI
Satisfaction, quality of life and perception of patients regarding burdens and benefits of vitamin K antagonists compared with direct oral anticoagulants in patients with nonvalvular atrial fibrillation.
Ma del Mar Contreras Muruaga,José Vivancos,Gemma Reig,Ayoze González,Pere Cardona,José Mª Ramírez-Moreno,Joan Martí,Carmen Suárez Fernández +7 more
TL;DR: Satisfaction and quality of life with oral anticoagulants were high, although they were both better with DOACs than with VKAs, which were more commonly prescribed in patients with a history of stroke and in Patients with a higher thromboembolic risk.
Journal ArticleDOI
Patient Satisfaction with Direct Oral Anticoagulants and Warfarin.
Yasuo Okumura,Katsuaki Yokoyama,Naoya Matsumoto,Eizo Tachibana,Keiichiro Kuronuma,Koji Oiwa,Michiaki Matsumoto,Toshiaki Kojima,Ken Arima,Tomobumi Kotani,Kazumiki Nomoto,Yukitoshi Ikeya,Seiji Fukushima,Motoyuki Onikura,Yasuko Suzuki,Masami Fujita,Hideyuki Ando,Norikazu Ishikawa,Atsushi Hirayama +18 more
TL;DR: The authors can expect greater burden satisfaction with anticoagulation treatment in patients given a DOAC versus VKA/warfarin, and the reduced burden of treatment will translate to greater patient adherence to their treatment plans and a positive effect on clinical outcomes.
Journal ArticleDOI
A systematic review of patient-reported outcomes associated with the use of direct-acting oral anticoagulants
TL;DR: This systematic review aimed to analyse the impact of PROs in patients on direct oral anticoagulant treatment, prescribed for any indication, using controlled trials (CT) and real‐world observational studies (OS).
Journal ArticleDOI
Satisfaction with oral anticoagulants in patients with atrial fibrillation.
Carmen Suárez Fernández,Luis Castilla-Guerra,Jesus Cantero Hinojosa,Josep Maria Suriñach,Fernando Acosta de Bilbao,Juan José Tamarit,José Luis Diaz Diaz,José L. Hernández,Antonio Pose,Manuel Montero-Pérez-Barquero,Jaume Roquer,J. Gállego,José Vivancos,José María Mostaza +13 more
TL;DR: Satisfaction with oral anticoagulation was high in patients with nonvalvular atrial fibrillation, who were attending internal medicine departments daily in Spain.
Journal ArticleDOI
Role of rivaroxaban in the management of atrial fibrillation: insights from clinical practice.
TL;DR: Real-world evidence supports the use of rivaroxaban as safe and effective in preventing ischemic stroke in non-valvular AF patients with comorbidities – including renal impairment, acute coronary syndrome, diabetes mellitus, malignancy, or old age – though with some important considerations required to reduce bleeding risk.
References
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Journal ArticleDOI
Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation
Manesh R. Patel,Kenneth W. Mahaffey,Jyotsna Garg,Guohua Pan,Daniel E. Singer,Werner Hacke,Günter Breithardt,Jonathan L. Halperin,Graeme J. Hankey,Jonathan P. Piccini,Richard C. Becker,Christopher C. Nessel,John F. Paolini,Scott D. Berkowitz,Robert M. Califf +14 more
TL;DR: In patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism and there was no significant between-group difference in the risk of major bleeding, although intracranial and fatal bleeding occurred less frequently in the rivroxaban group.
Journal ArticleDOI
Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation
TL;DR: An updated meta-analysis of all currently available randomized trials that extends observations about the efficacy and safety of antithrombotic therapies for preventing stroke in patients who have atrial fibrillation is presented.
Journal ArticleDOI
Oral Anticoagulant Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Walter Ageno,Alexander Gallus,Ann K. Wittkowsky,Mark Crowther,Elaine M. Hylek,Gualtiero Palareti +5 more
TL;DR: There is a large amount of evidence on laboratory and clinical characteristics of vitamin K antagonists and a growing body of evidence is becoming available on the first new oral anticoagulant drugs available for clinical use, dabigatran and rivaroxaban.
Journal ArticleDOI
Methods to explain the clinical significance of health status measures.
TL;DR: One can classify ways to establish the interpretability of quality-of-life measures as anchor based or distribution based, which relies on an independent standard or anchor that is itself interpretable and at least moderately correlated with the instrument being explored.
Journal ArticleDOI
Risk Profiles and Antithrombotic Treatment of Patients Newly Diagnosed with Atrial Fibrillation at Risk of Stroke: Perspectives from the International, Observational, Prospective GARFIELD Registry
Ajay K. Kakkar,Iris Mueller,Jean-Pierre Bassand,David Fitzmaurice,Samuel Z. Goldhaber,Shinya Goto,Sylvia Haas,Werner Hacke,Gregory Y.H. Lip,Lorenzo G. Mantovani,Alexander G.G. Turpie,Martin van Eickels,Frank Misselwitz,Sophie Rushton-Smith,Gloria Kayani,Peter Wilkinson,Freek W.A. Verheugt +16 more
TL;DR: Current observational worldwide data on non-valvular atrial fibrillation, collected at the end of the vitamin K antagonist-only era, indicate that these drugs are frequently not being used according to stroke risk scores and guidelines, with overuse in patients at low risk and underuse in those at high risk of stroke.