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Discontinuation of anticoagulant treatment: from clinical trials to medication persistence

Authors: András Komócsi;

Discontinuation of anticoagulant treatment: from clinical trials to medication persistence

Abstract

The new generation, non-vitamin K antagonist oral anticoagulants are used in an increasing frequency, partially replacing the vitamin K antagonists in several fields of anticoagulation. Efficacy of the preventive oral anticoagulant regime, however, may be compromised by patient non-compliance.The authors analyzed treatment discontinuation frequencies in phase 3 trials of anticoagulant treatment in non-valvular atrial fibrillation in a frequentist random effect metaanalysis and in Bayesian multiple treatment network comparison.Frequency of discontinuations are heterogeneous and highly inconsistent (Chi2 test for heterogeneity p < 0.001, I2 test for inconsistency 95.1%). Discontinuations were the most frequent with dabigatran followed by rivaroxaban, warfarin, edoxaban and apixaban. Rivaroxaban were less frequently discontinued when compared to the two doses of dabigatran. (OR 0.80; 95% CI: 0.71-0.91 versus 150 mg b.i.d., and OR: 0.77; 95% CI: 0.68-0.87 versus 110 mg b.i.d.).Important differences exist among the treatment adherence of different anticoagulant protocols. Discontinuation rates experienced during the clinical trials may predict the real life patient adherence.

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Keywords

Male, Rivaroxaban, Atrial Fibrillation, Anticoagulants, Humans, Female, Dabigatran

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    9
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Found an issue? Give us feedback
citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
9
Average
Average
Top 10%
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