Coverage of the 67th Scientific Session of the American College of Cardiology.
An analysis of claims data from 180 million people—half the US population—has found that the direct oral anticoagulant (DOAC) apixaban (Eliquis, Bristol-Myers Squibb/Pfizer) had lower rates of major bleeding and stroke/systemic embolism in a series of head-to-head comparisons among apixaban, dabigatran, and rivaroxaban.
The study was presented Sunday at the 67th Scientific Session of the American College of Cardiology in Orlando, Florida.
The 3 best-selling DOACs are alternatives to traditional anticoagulants, such as warfarin, which require monthly blood tests and dietary restrictions. DOACs require less monitoring for stroke prevention and clear the system more quickly when necessary.
Researchers for ARISTOPHANES started with CMS claims data and 4 large commercial databases (Truven MarketScan, IMS PharMetrics Plus, Optum Clinformatics Data Mart, and the Humana Research Database). From here, they culled records for 162,707 patients with non-valvular atrial fibrillation, for the period between January 1, 2013, and September 30, 2015. Three DOAC-to-DOAC comparisons were done for each database, and then the results were pooled. Patients were followed for 6 months.
Results were as follows:
Steven B. Deitelzweig, MD, MMM, SFHM, FACP FACC, medical director of Regional Business Development at Oschner Medical Center in New Orleans, Louisiana, said the large size of the data set was a strength of the study. “This has been shown before in single databases, so it’s more confirmatory,” he said.
Sharing the results with payers will be the next step, Deitelzweig said. With lower event rates, and knowing that a major bleeding event means a trip to the hospital, “it’s not hard to enter into the cost discussion, which should be compelling for them, given the scale.”
Real-world data also revealed that the results held up even at lower doses of the drug, which is prescribed much more frequently than in clinical trials, Deitelzweig said. Apixaban is available in 2.5 mg and 5 mg tablets.
Bristol-Myers Squibb and Pfizer funded the study.
Reference
Deitelzweig S, Keshishian A, Li X, et al. Comparison of effectiveness, safety, and the net clinical outcome between direct oral anticoagulants in 162,707 non-valvular atrial fibrillation patients treated in US clinical practice. Presented at the 67th Scientific Session of the American College of Cardiology, Orlando, Florida, March 11, 2018. Abstract 900-10.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More