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All-Cause, Stroke-, and Bleed-Specific Healthcare Costs: Comparison among Patients with Non-Valvular Atrial Fibrillation (NVAF) Newly Treated with Dabigatran or Warfarin
ConclusionPatients receiving dabigatran had significantly lower total all-cause, inpatient, and outpatient costs but higher pharmacy costs than those receiving warfarin. In addition, stroke-specific total and outpatient costs and bleed-specific total and inpatient costs were significantly lower in dabigatran users compared with warfarin users.
Source: American Journal of Cardiovascular Drugs - August 9, 2017 Category: Cardiology Source Type: research

Challenges and Treatment for Stroke Prophylaxis in Patients with Atrial Fibrillation in Mexico: A Review
Abstract Atrial fibrillation (AF) is associated with an increased risk of stroke. AF-related strokes cause greater disability and mortality than those in patients without AF, and are associated with a significant clinical and economic burden in Mexico. Antithrombotic therapy reduces stroke risk in patients with AF and is recommended for all patients except those classified as having a low stroke risk. However, its use is suboptimal all around the world; one study showed that only 4 % of Mexican patients with AF who presented with ischemic stroke were in the therapeutic range for anticoagulation. Vitamin K antagon...
Source: American Journal of Cardiovascular Drugs - February 29, 2016 Category: Cardiology Source Type: research

Comparing Stroke and Bleeding with Rivaroxaban and Dabigatran in Atrial Fibrillation: Analysis of the US Medicare Part D Data
ConclusionsThere was no difference in stroke prevention between rivaroxaban and dabigatran; however, rivaroxaban was associated with a higher risk of thromboembolic events other than stroke, death, and bleeding.
Source: American Journal of Cardiovascular Drugs - September 13, 2016 Category: Cardiology Source Type: research

Cost Effectiveness of New Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation in Two Different European Healthcare Settings
Conclusions Apixaban, rivaroxaban, and dabigatran are cost-effective alternatives to coumarin derivatives in the UK, while in the Netherlands, only apixaban and dabigatran could be considered cost effective. The cost effectiveness of the new oral anticoagulants is largely dependent on the setting and quality of local anticoagulant care facilities.
Source: American Journal of Cardiovascular Drugs - October 18, 2014 Category: Cardiology Source Type: research

Comparing the Cost Effectiveness of Non-vitamin K Antagonist Oral Anticoagulants with Well-Managed Warfarin for Stroke Prevention in Atrial Fibrillation Patients at High Risk of Bleeding
ConclusionsThe comparative cost effectiveness of edoxaban and warfarin is highly sensitive to TTR. At the $US100,000/QALY willingness-to-pay threshold, our results suggest that warfarin is the most cost-effective treatment for patients who can achieve a TTR of 70%.
Source: American Journal of Cardiovascular Drugs - May 9, 2018 Category: Cardiology Source Type: research

Integrating Real-World Evidence in Economic Evaluation of Oral Anticoagulants for Stroke Prevention in Non-valvular Atrial Fibrillation in a Developing Country
ConclusionsIn a developing country where suboptimal anticoagulation control is common, apixaban was the cost-effective alternative to warfarin for patients with both low and intermediate TTR control.
Source: American Journal of Cardiovascular Drugs - February 3, 2023 Category: Cardiology Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants: New Choices for Patient Management in Atrial Fibrillation
Abstract Atrial fibrillation (AF) is a significant problem for the aging population and remains a major factor underlying stroke risk. Warfarin anticoagulation has been proven effective for stroke prevention in AF, but can be difficult to manage and requires frequent monitoring. The non-vitamin K antagonist oral anticoagulants (NOACs) have been shown to be as effective as warfarin for stroke prevention in nonvalvular AF (NVAF) and are associated with a reduced risk of bleeding compared with warfarin. Dabigatran, rivaroxaban, apixaban, and edoxaban have been approved in the USA for reducing the risk of stroke in pa...
Source: American Journal of Cardiovascular Drugs - June 9, 2015 Category: Cardiology Source Type: research

A Summary of the Literature Evaluating Adherence and Persistence with Oral Anticoagulants in Atrial Fibrillation
Abstract Atrial fibrillation (AF) is a growing public health concern and remains an independent risk factor for ischemic stroke. Warfarin, a commonly used oral anticoagulant, is associated with a 60–70 % relative reduction in stroke risk and a reduction in mortality of 26 %. However, warfarin has several limitations, including a narrow therapeutic window, variable dose response, multiple interactions with other drugs and concurrent illnesses, and the need for frequent laboratory monitoring. In recent years, the direct acting oral anticoagulants (DOACs), including dabigatran, rivaroxaban, apixaban and edoxaban,...
Source: American Journal of Cardiovascular Drugs - June 3, 2016 Category: Cardiology Source Type: research

Comparative Real-Life Effectiveness and Safety of Dabigatran or Rivaroxaban vs. Vitamin K Antagonists: A High-Dimensional Propensity Score Matched New Users Cohort Study in the French National Healthcare Data System SNDS
ConclusionConsistent with results from clinical trials and other observational studies, dabigatran and rivaroxaban were at least as effective and safer than VKAs for the prevention of thromboembolic events in NVAF over 1 year in the French population.Study registrationEuropean Medicines Agency EUPAS 13017 (www.encepp.eu) Clinicaltrials.gov id NCT02785354.
Source: American Journal of Cardiovascular Drugs - June 28, 2019 Category: Cardiology Source Type: research

Non-persistence to Oral Anticoagulation Treatment in Patients with Non-valvular Atrial Fibrillation in the USA
ConclusionIn over one million patients with NVAF, our results suggest differences in anticoagulation treatment persistence across OAC agents, even after accounting for clinical events after OAC initiation. It is important for clinicians and patients to take these differences into consideration, especially as non-persistence to OAC therapy is associated with thromboembolic complications.
Source: American Journal of Cardiovascular Drugs - October 21, 2021 Category: Cardiology Source Type: research

Outcomes After Cardioversion in Atrial Fibrillation Patients Treated with Non-Vitamin K Antagonist Oral Anticoagulants (NOACs): Insights from a Meta-Analysis
Conclusions Data from patients enrolled in RCTs, showed that NOACs are effective and safe for AF patients undergoing cardioversion.
Source: American Journal of Cardiovascular Drugs - July 2, 2015 Category: Cardiology Source Type: research

Effectiveness and Safety of Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation and Weighing ≥ 120 Kilograms versus 60–120 Kilograms
ConclusionApixaban, dabigatran, or rivaroxaban may be well-tolerated and effective anticoagulant options in patients with NVAF weighing ≥ 120 kg.
Source: American Journal of Cardiovascular Drugs - March 30, 2021 Category: Cardiology Source Type: research

Time to Reconsider Dabigatran 110 mg in the USA
Abstract Unlike other international regulatory agencies, the US FDA did not approve the dabigatran 110 mg dose for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Such decision was based on the review of the results from the RE-LY trial, after which the US FDA concluded there was no subgroup of patients for whom dabigatran 110 mg was not inferior to dabigatran 150 mg. Recently, observational studies based on US data have found that the safety profile of dabigatran differs between subgroups, considerably more than what was suggested in clinical trials. In additio...
Source: American Journal of Cardiovascular Drugs - June 12, 2015 Category: Cardiology Source Type: research

Tolerability and Acceptability of Non-Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation: Systematic Review and Meta-Analysis
Conclusions NOACs were associated with a small, yet significant, risk reduction of SAEs in patients with AF. NOACs’ drug-related and patient-related acceptability profiles were similar to those for VKAs. The results were heterogeneous mainly because of the increased rate of discontinuation associated with dabigatran. Pragmatic trials and cohort studies should be conducted to further address these important clinical questions.
Source: American Journal of Cardiovascular Drugs - June 20, 2015 Category: Cardiology Source Type: research

Reversing the Effect of Oral Anticoagulant Drugs: Established and Newer Options
Abstract The vitamin K antagonists (VKAs) have been the standard (and only) oral anticoagulants used for the long-term treatment or prevention of venous thromboembolism or stroke in patients with atrial fibrillation. The coagulopathy induced by VKAs can be reversed with vitamin K, and in urgent situations, the vitamin K-dependent coagulation factors can be replaced by transfusion. In the last decade, a new class of oral anticoagulants has been developed, direct oral anticoagulants that bind to a specific coagulation factor and neutralize it. These compounds were shown to be effective and safe compared with the VKA...
Source: American Journal of Cardiovascular Drugs - February 12, 2016 Category: Cardiology Source Type: research

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