Medication adherence to rivaroxaban and dabigatran in patients with non-valvular atrial fibrillation: a meta-analysis

被引:0
作者
Ashley Prentice
Irene Ruiz
Erin R. Weeda
机构
[1] Medical University of South Carolina,College of Pharmacy
来源
Journal of Thrombosis and Thrombolysis | 2020年 / 49卷
关键词
Medication adherence; Direct oral anticoagulant; Atrial fibrillation; Proportion of days covered;
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摘要
Several real-world studies have evaluated adherence to direct acting oral anticoagulants in patients with non-valvular atrial fibrillation (NVAF); however, these studies have not been systematically summarized. We performed a meta-analysis to compare adherence to rivaroxaban versus dabigatran therapy in United States (US) patients with NVAF in a real-world setting. Medline and Scopus were searched from January 2010 to August 2018 using keywords and MeSH terms related to adherence and oral anticoagulants. We included real-world studies of US adults with NVAF comparing adherence to dabigatran and rivaroxaban. Studies evaluating adherence by a measure other than proportion of days covered (PDC) were excluded. The proportion of patients with a PDC ≥ 80 (a commonly utilized definition of adherence) served as the primary outcome of interest. We conducted meta-analysis of non-overlapping studies using the Hartung–Knapp random-effects model to estimate risk ratios (RRs) with corresponding 95% confidence intervals (CIs). We included 5 studies evaluating 80,230 patients (range 2667–22,571). Median follow-up across studies was 6 months (range 3–12 months). The proportion of patients with a PDC ≥ 80 ranged from 59.5 to 83.5% for rivaroxaban users and 57.3 to 78.3% for dabigatran users. Upon meta-analysis, rivaroxaban use was associated with increased adherence compared with dabigatran use (RR  1.08; 95% CI  1.03–1.12; I2 = 88%). In conclusion, rivaroxaban was associated with increased adherence when compared to dabigatran in ~ 80,000 patients in a real-world setting. Possible explanations for this include dosing frequency or patient tolerance.
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页码:360 / 364
页数:4
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