Incidence of direct oral anticoagulant use in patients with nonvalvular atrial fibrillation and characteristics of users in 6 European countries (2008-2015) : A cross-national drug utilization study
Ibáñez, Luisa (Universitat Autònoma de Barcelona)
Sabaté, Mònica (Universitat Autònoma de Barcelona)
Vidal Guitart, Xavier (Universitat Autònoma de Barcelona)
Ballarín, Elena (Hospital Universitari Vall d'Hebron)
Rottenkolber, Marietta (Klinikum der Universität München)
Schmiedl, Sven (Helios University Hospital Wuppertal)
Heeke, Andreas (AOK NORDWEST)
Huerta, Consuelo (Agencia Española de Medicamentos y Productos Sanitarios)
Martin Merino, Elisa (Agencia Española de Medicamentos y Productos Sanitarios)
Montero, Dolores (Agencia Española de Medicamentos y Productos Sanitarios)
Leon-Muñoz, Luz María (Agencia Española de Medicamentos y Productos Sanitarios)
Gasse, Christiane (Aarhus University)
Moore, Nicholas (INSERM CIC1401, Université de Bordeaux)
Droz, Cécile (INSERM CIC1401, Université de Bordeaux)
Lassalle, Régis (INSERM CIC1401, Université de Bordeaux)
Aakjær, Mia (University of Copenhagen)
Andersen, Morten (University of Copenhagen)
De Bruin, Marie Louise (University of Copenhagen)
Groenwold, Rolf (Leiden University Medical Center)
van den Ham, Hendrika A. (Universiteit Utrecht, David de Wiedgebouw)
Souverein, Patrick (Universiteit Utrecht, David de Wiedgebouw)
Klungel, Olaf (University Medical Center Utrecht)
Gardarsdottir, Helga (University of Iceland)
Universitat Autònoma de Barcelona
Hospital Universitari Vall d'Hebron

Date:	2019
Abstract:	To estimate the incidence of direct oral anticoagulant drug (DOAC) use in patients with nonvalvular atrial fibrillation and to describe user and treatment characteristics in 8 European healthcare databases representing 6 European countries. Longitudinal drug utilization study from January 2008 to December 2015. A common protocol approach was applied. Annual period incidences and direct standardisation by age and sex were performed. Dose adjustment related to change in age and by renal function as well as concomitant use of potentially interacting drugs were assessed. A total of 186 405 new DOAC users (age ≥18 years) were identified. Standardized incidences varied from 1. 93-2. 60 and 0. 11-8. 71 users/10 000 (2011-2015) for dabigatran and rivaroxaban, respectively, and from 0. 01-8. 12 users/10 000 (2012-2015) for apixaban. In 2015, the DOAC incidence ranged from 9 to 28/10 000 inhabitants in SIDIAP (Spain) and DNR (Denmark) respectively. There were differences in population coverage among the databases. Only 1 database includes the total reference population (DNR) while others are considered a population representative sample (CPRD, BIFAP, SIDIAP, EGB, Mondriaan). They also varied in the type of drug data source (administrative, clinical). Dose adjustment ranged from 4. 6% in BIFAP (Spain) to 15. 6% in EGB (France). Concomitant use of interacting drugs varied between 16. 4% (SIDIAP) and 70. 5% (EGB). Cardiovascular comorbidities ranged from 25. 4% in Mondriaan (The Netherlands) to 82. 9% in AOK Nordwest (Germany). Overall, apixaban and rivaroxaban increased its use during the study period while dabigatran decreased. There was variability in patient characteristics such as comorbidities, potentially interacting drugs and dose adjustment. (EMA/2015/27/PH).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Anticoagulants ; Arrhythmia ; Cardiovascular ; Drug utilization ; Pharmacoepidemiology
Published in:	British Journal of Clinical Pharmacology, Vol. 85 (september 2019) , p. 2524-2539, ISSN 1365-2125

DOI: 10.1111/bcp.14071
PMID: 31318059

16 p, 1.2 MB

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