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Background: Novel oral anti-coagulation therapies (NOAC) have now become the standard of care treatment among patients at risk of stroke with non-valvular atrial fibrillation (AF) in the US. NOAC use has significantly increased since the first therapies were launched in late 2010. This paper examines which patients are being prescribed NOACs in comparison to the more conventional treatment, warfarin.
Methods: Ipsos Healthcare's Therapy Monitor for Stroke Prevention in Atrial Fibrillation (SPAF) has been collecting patient chart data since 2013; and in 2016 data was collected from 5,700 patients across 10 global markets.
Results: Since 2013 there has been an increase in the use of novel oral anticoagulants (NOAC). In the US, total NOAC share increased from 42% in 2013 to 61% in 2016 whilst warfarin share decreased from 38% in 2013 to 27% in 2016 (total patient number: n2013=1,252; n2016=1,400). Although the newer drugs come with obvious convenience advantages, Ipsos data also indicates that there are some significant differences between warfarin and NOAC treated patients. 72% of NOAC patients (n=859) are under the age of 75 compared to 57% of warfarin patients (n=374); 48% of NOAC patients have no renal impairment compared to 33% among warfarin patients; and 57% and 43% are the low bleed risk rates among patients treated by NOACs and warfarin, respectively. This indicates that NOAC patients are typically younger, have better renal function and lower bleed risk compared to warfarin treated patients.
Conclusions: This data indicates that the trend seen in the uptake in NOAC use among stroke prevention in atrial fibrillation (SPAF) patients is driven by healthier patients; and it is likely that there will remain a role for warfarin in the management of patients with SPAF particularly among those patients with more complicated profiles (high bleed risk and renal impairment).
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias and Clinical EP: Basic 1
Abstract Category: 4. Arrhythmias and Clinical EP: Basic
Presentation Number: 1107-076
- 2017 American College of Cardiology Foundation