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.
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
Survey Results Reveal Potential Factors Slowing the Decline in Cardiovascular Mortality Rate
April 23rd 2024Research indicated that worsened glycemic, blood pressure, and obesity control, as well as increased alcohol consumption, leveled lipid control, and persistent socioeconomic disparities may have contributed to the decelerated cardiovascular mortality decline in recent years.
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
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
Read More