Characteristics of patients with AF and matched controls.

<p>Characteristics of patients with AF and matched controls.</p

Adjusted health outcomes in patients with AF and matched controls.

<p>Adjusted health outcomes in patients with AF and matched controls.</p

Adjusted healthcare resource use and depression, pain, and insomnia, in patients with AF and matched controls.

<p>Adjusted healthcare resource use and depression, pain, and insomnia, in patients with AF and matched controls.</p

Overall Humanistic Burden as a function of AF, demographics, comorbidities, and behavioral factors.

<p><i>Note.</i> Nonsignificant predictors of burden are not presented above: non-white; single; divorced/widowed/separated; college education or higher; household income: $25,000 to$49,999, $50,000 to$74,999, and decline to answer; uninsured; BMI: overweight. Reference groups include: non-AF matched controls, male, white, married/living with partner, less than college education, household income:<$25,000, insured, BMI: underweight/normal, unemployed, not exercising, not currently smoking, not using alcohol, comorbidity count of 0, and CHADS2 low risk. Standardized estimates and residual variances are shown. Topmost indicators per factor set the scale. Dichotomous indicators include “(0/1).” *p<0.05. **p<0.01. ***p<0.001. No p-values are available for the scale setters and categorical residuals.</p

Discontinuation risk comparison among ‘real-world’ newly anticoagulated atrial fibrillation patients: Apixaban, warfarin, dabigatran, or rivaroxaban

<div><p>Discontinuation of oral anticoagulants may expose non-valvular atrial fibrillation (NVAF) patients to an increased risk of stroke. This study describes the real-world discontinuation rates and compared the risk of drug discontinuation among NVAF patients initiating apixaban, warfarin, dabigatran, or rivaroxaban. This retrospective cohort study evaluated newly-anticoagulated NVAF patients in the MarketScan^® data population from 01/01/2012 through 12/31/2014. Discontinuation was defined as a lack of subsequent prescription of the index drug within 30 days after the last supply day of the last prescription. A Cox model was used to estimate the hazard ratio (HR) of discontinuation, adjusted for age, sex, and comorbidities. Among 45,361 eligible NVAF patients, 15,461 (34.1%) initiated warfarin; 7,438 (16.4%) apixaban; 4,661 (10.3%) dabigatran; and 17,801 (39.2%) initiated rivaroxaban treatment. Compared to warfarin, patients who initiated dabigatran (adjusted HR [aHR]: 0.84, 95% confidence interval [CI]: 0.80–0.87, P<0.001), rivaroxaban (aHR: 0.70, 95% CI: 0.68–0.73, P<0.001), or apixaban (aHR: 0.57, 95% CI: 0.55–0.60, P<0.001) were 16%, 30%, and 43% less likely to discontinue treatment, respectively. When compared to apixaban, patients who initiated dabigatran (aHR: 1.46, 95% CI: 1.38–1.54, P<0.001) or rivaroxaban (aHR: 1.23, 95% CI: 1.17–1.28, P<0.001) were more likely to discontinue treatment. Among newly-anticoagulated NVAF patients in the real-world setting, initiation on rivaroxaban, dabigatran, or apixaban was associated with a significantly lower risk of discontinuation compared to warfarin. When compared to apixaban, patients who initiated treatment with warfarin, dabigatran, or rivaroxaban were more likely to discontinue treatment.</p></div

Cumulative incidence of discontinuation among newly anticoagulated non-valvular atrial fibrillation patients.

<p>(Upper panel) Cumulative incidence of discontinuation during the follow-up period. The unadjusted cumulative incidence of discontinuation was lower among patients initiated on apixaban compared to patients inititated on other oral anticoagulants. (Lower panel) The number of patients at risk for discontinuation at varying points during the follow-up.</p

Baseline patient characteristics and treatment follow-up period.

<p>Baseline patient characteristics and treatment follow-up period.</p

Patient selection criteria.

<p>Study population flow chart with inclusion and exclusion criteria used to select 45,361 patients. NOAC: non-vitamin K antagonist oral anticoagulant; VTE: venous thromboembolism.</p

Adjusted hazard ratios of discontinuation.

<p>Adjusted hazard ratios of discontinuation.</p

Study period depiction.

<p>Study period for patients initiating apixaban, dabigatran, rivaroxaban, and warfarin. AF: atrial fibrillation.</p