Non-valvular Atrial Fibrillation
Conditions
Keywords
Non-valvular atrial fibrillation, NVAF
Brief summary
An anticoagulation therapy is a critical treatment to prevent thromboembolism in non-valvular AF (NVAF) patients. Warfarin, a vitamin K antagonist, is the first oral anticoagulant approved for the treatment for prevention of thromboembolism and it had long been the only oral anticoagulant until the first non-vitamin K antagonist oral anticoagulants (NOACs). However, its safety and effectiveness remains unknown in real-world clinical practice in Japan
Detailed description
An anticoagulation therapy is a critical treatment to prevent thromboembolism in non-valvular AF (NVAF) patients. Warfarin, a vitamin K antagonist, is the first oral anticoagulant approved for the treatment for prevention of thromboembolism and it had long been the only oral anticoagulant until the first non-vitamin K antagonist oral anticoagulants (NOACs). However, its safety and effectiveness remains unknown in real-world clinical practice in Japan. This study will evaluate the risk of stroke/SE as well as the risk of bleeding in the real world settings in Japan in patients with NVAF who initiated any of OACs (apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin)
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
Patients must meet all of the following criteria to be eligible for the study: 1. Diagnosed with AF anytime in the baseline period or on the index date, also have definitive diagnosis of AF anytime in the baseline period, on the index date, or post-index period. 2. Prescribed one of the index OACs (apixaban, dabigatran, edoxaban, rivaroxaban or warfarin) on or after the day of AF diagnosis. The first observed prescription will be used to identify the patient's index date and treatment cohort 3. No use of the any OACs during the baseline period (the 180 days before the index date) 4. Age of 18 years or older on the index date.
Exclusion criteria
Patients meeting any of the following criteria will not be included in the study: 1\. Having a diagnosis of valvular atrial fibrillation, post-operative atrial fibrillation, rheumatic atrial fibrillation or mechanical-valvular atrial fibrillation during the baseline and post-index period 2. Having a cardiac surgery procedure record during the baseline period 3. Having a joint replacement procedure record during the baseline period 4. Having a procedure of prosthetic heart valve during the baseline period 5. Having a diagnosis of venous thromboembolism during the baseline period 6. Female patients with pregnancy during the follow-up period 7. Patients prescribed off-label doses of OACs (per Japanese package insert of each OAC) or patients treated with OAC but in off-label or contraindicated manners. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of stroke and systemic embolism events after index date was reported. Stroke events included the composite of any ischemic and any hemorrhagic stroke events (non-traumatic extradural hemorrhage). Systemic embolism events were defined as any of the following: abdominal aortic embolism, aortic embolism, acute arterial occlusive disease of arteries of upper extremities, femoral arterial occlusion and acute arterial occlusive disease of arteries of lower extremities, iliac artery embolism, hepatic artery embolism, thromboembolism, embolic infarction, aortic embolism, subclavian artery stenosis. Index date was defined as date of first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of major bleeding event after index date was reported. Major bleeding after index date was identified using hospital claims which had a bleeding diagnosis code as the first listed in International Statistical Classification of Diseases and Related Health Problems (ICD)-10 diagnosis code. An event occurrence of major bleeding was defined as that appears as 21: Disease name behind hospitalization in database. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of any bleeding event after index date was reported. Any bleeding was defined using ICD-10 diagnosis codes and participants were considered to have any bleeding if pre-defined bleeding-associated ICD-10 diagnosis codes appeared in the records. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of major gastrointestinal bleeding events after index date was reported. Major gastrointestinal bleeding after index date was identified using hospital claims which had a gastrointestinal bleeding diagnosis code as the first listed ICD-10 diagnosis code. An event occurrence of major bleeding was defined as that appears as 21: Disease name behind hospitalization in database. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of any gastrointestinal bleeding event after index date was reported. Any gastrointestinal bleeding was defined by ICD-10 diagnosis codes. If participants had ICD-10 diagnosis codes which suggest bleeding from the gastrointestinal tract, they were considered to have any gastrointestinal bleeding. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of ischemic stroke after index date was reported. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of any intracranial hemorrhage event after index date was reported. Any intracranial hemorrhage was defined by ICD-10 diagnosis codes and participants were considered to have any intracranial hemorrhagic event if pre-defined any intracranial hemorrhagic-associated ICD-10 diagnosis codes appeared in the records. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of major intracranial hemorrhage events after index date was reported. Major intracranial hemorrhage was defined by ICD-10 diagnosis codes and participants were considered to have major intracranial hemorrhage if pre-defined major intracranial hemorrhagic-associated ICD-10 diagnosis codes appeared in the records. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of hemorrhagic stroke after index date was reported. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
| Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date | During the observation period of approximately 7 years | Event rate per 100 participant-years for first occurrence of systemic embolism events after index date was reported. Systemic embolism events included any of the following: abdominal aortic embolism, aortic embolism, acute arterial occlusive disease of arteries of upper extremities, femoral arterial occlusion and acute arterial occlusive disease of arteries of lower extremities, iliac artery embolism, hepatic artery embolism, thromboembolism, embolic infarction, aortic embolism, subclavian artery stenosis. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm. |
Countries
Japan
Participant flow
Recruitment details
It is a retrospective population-based register study. Data of each participant diagnosed with non-valvular atrial fibrillation (NAVF) was retrieved from Medical Data Vision (MDV) database for the duration of approximately 7 years (March 2011 to December 2017).
Pre-assignment details
In this study, inverse probability of treatment weighted (IPTW) method was used in analysis of outcome measures to balance participant's characteristics among reporting groups.
Participants by arm
| Arm | Count |
|---|---|
| Warfarin OACs treatment-naive participants diagnosed with NVAF, who initiated warfarin on the index date, were included in this study cohort and their data (for the duration of approximately 7 years observation period, i.e. 2011-2017) available in MDV database was retrospectively observed. Index date was defined as the date of the first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during observation period. | 15,902 |
| Apixaban OACs treatment-naive participants diagnosed with NVAF, who initiated apixaban on the index date, were included in this study cohort and their data (for the duration of approximately 7 years observation period, i.e. 2011-2017) available in MDV database was retrospectively observed. Index date was defined as the date of the first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during observation period. | 22,336 |
| Dabigatran OACs treatment-naive participants diagnosed with NVAF, who initiated dabigatran on the index date, were included in this study cohort and their data (for the duration of approximately 7 years observation period, i.e. 2011-2017) available in MDV database was retrospectively observed. Index date was defined as the date of the first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during observation period. | 6,925 |
| Rivaroxaban OACs treatment-naive participants diagnosed with NVAF, who initiated rivaroxaban on the index date, were included in this study cohort and their data (for the duration of approximately 7 years observation period, i.e. 2011-2017) available in MDV database was retrospectively observed. Index date was defined as the date of the first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during observation period. | 16,564 |
| Edoxaban OACs treatment-naive participants diagnosed with NVAF, who initiated edoxaban on the index date, were included in this study cohort and their data (for the duration of approximately 7 years observation period, i.e. 2011-2017) available in MDV database was retrospectively observed. Index date was defined as the date of the first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during observation period. | 12,262 |
| Total | 73,989 |
Baseline characteristics
| Characteristic | Warfarin | Apixaban | Dabigatran | Rivaroxaban | Edoxaban | Total |
|---|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 14590 Participants | 20038 Participants | 5594 Participants | 13859 Participants | 10811 Participants | 64892 Participants |
| Age, Categorical Between 18 and 65 years | 1312 Participants | 2298 Participants | 1331 Participants | 2705 Participants | 1451 Participants | 9097 Participants |
| Race and Ethnicity Not Collected | — | — | — | — | — | 0 Participants |
| Sex: Female, Male Female | 6257 Participants | 9131 Participants | 2184 Participants | 5818 Participants | 5331 Participants | 28721 Participants |
| Sex: Female, Male Male | 9645 Participants | 13205 Participants | 4741 Participants | 10746 Participants | 6931 Participants | 45268 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk |
|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
Outcome results
Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date
Event rate per 100 participant-years for first occurrence of any bleeding event after index date was reported. Any bleeding was defined using ICD-10 diagnosis codes and participants were considered to have any bleeding if pre-defined bleeding-associated ICD-10 diagnosis codes appeared in the records. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date | 22.11 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date | 15.97 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date | 15.9 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date | 16.07 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Bleeding Event After Index Date | 20.34 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date
Event rate per 100 participant-years for first occurrence of major bleeding event after index date was reported. Major bleeding after index date was identified using hospital claims which had a bleeding diagnosis code as the first listed in International Statistical Classification of Diseases and Related Health Problems (ICD)-10 diagnosis code. An event occurrence of major bleeding was defined as that appears as 21: Disease name behind hospitalization in database. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date | 3.13 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date | 1.79 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date | 1.72 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date | 1.82 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Bleeding Events After Index Date | 1.91 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date
Event rate per 100 participant-years for first occurrence of stroke and systemic embolism events after index date was reported. Stroke events included the composite of any ischemic and any hemorrhagic stroke events (non-traumatic extradural hemorrhage). Systemic embolism events were defined as any of the following: abdominal aortic embolism, aortic embolism, acute arterial occlusive disease of arteries of upper extremities, femoral arterial occlusion and acute arterial occlusive disease of arteries of lower extremities, iliac artery embolism, hepatic artery embolism, thromboembolism, embolic infarction, aortic embolism, subclavian artery stenosis. Index date was defined as date of first prescription of any OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date | 3.2 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date | 1.67 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date | 2.08 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date | 1.79 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Stroke and Systemic Embolism Events After Index Date | 2 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date
Event rate per 100 participant-years for first occurrence of any gastrointestinal bleeding event after index date was reported. Any gastrointestinal bleeding was defined by ICD-10 diagnosis codes. If participants had ICD-10 diagnosis codes which suggest bleeding from the gastrointestinal tract, they were considered to have any gastrointestinal bleeding. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date | 5.98 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date | 4.11 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date | 4.75 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date | 4.07 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Gastrointestinal Bleeding Event After Index Date | 5.42 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date
Event rate per 100 participant-years for first occurrence of any intracranial hemorrhage event after index date was reported. Any intracranial hemorrhage was defined by ICD-10 diagnosis codes and participants were considered to have any intracranial hemorrhagic event if pre-defined any intracranial hemorrhagic-associated ICD-10 diagnosis codes appeared in the records. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date | 4.16 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date | 2.93 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date | 2.43 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date | 2.66 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Any Intracranial Hemorrhage Event After Index Date | 3.65 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date
Event rate per 100 participant-years for first occurrence of hemorrhagic stroke after index date was reported. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date | 0.72 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date | 0.43 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date | 0.25 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date | 0.36 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Hemorrhagic Stroke After Index Date | 0.43 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date
Event rate per 100 participant-years for first occurrence of ischemic stroke after index date was reported. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date | 2.4 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date | 1.2 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date | 1.76 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date | 1.41 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Ischemic Stroke After Index Date | 1.54 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date
Event rate per 100 participant-years for first occurrence of major gastrointestinal bleeding events after index date was reported. Major gastrointestinal bleeding after index date was identified using hospital claims which had a gastrointestinal bleeding diagnosis code as the first listed ICD-10 diagnosis code. An event occurrence of major bleeding was defined as that appears as 21: Disease name behind hospitalization in database. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date | 1.02 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date | 0.61 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date | 0.77 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date | 0.74 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Gastrointestinal Bleeding Events After Index Date | 0.73 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date
Event rate per 100 participant-years for first occurrence of major intracranial hemorrhage events after index date was reported. Major intracranial hemorrhage was defined by ICD-10 diagnosis codes and participants were considered to have major intracranial hemorrhage if pre-defined major intracranial hemorrhagic-associated ICD-10 diagnosis codes appeared in the records. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date | 1.22 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date | 0.57 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date | 0.43 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date | 0.5 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Major Intracranial Hemorrhage Events After Index Date | 0.62 Events Per 100 Participant-Years |
Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date
Event rate per 100 participant-years for first occurrence of systemic embolism events after index date was reported. Systemic embolism events included any of the following: abdominal aortic embolism, aortic embolism, acute arterial occlusive disease of arteries of upper extremities, femoral arterial occlusion and acute arterial occlusive disease of arteries of lower extremities, iliac artery embolism, hepatic artery embolism, thromboembolism, embolic infarction, aortic embolism, subclavian artery stenosis. Index date was defined as the date of the first prescription of any of OACs (warfarin, apixaban, dabigatran, rivaroxaban or edoxaban) during the observation period of approximately 7 years (2011-2017). Pseudo datasets refers to number derived using IPTW method and are different from the actual participants included in the reporting arm.
Time frame: During the observation period of approximately 7 years
Population: OACs treatment-naive participants diagnosed with NVAF, initiating any OACs treatment were included in study. Analysis performed using IPTW method to balance participant characteristics among reporting groups. IPTW method created weighted pseudo-datasets which were used in analysis of outcome measure and are reported in the units analyzed field.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Warfarin | Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date | 0.11 Events Per 100 Participant-Years |
| Apixaban | Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date | 0.04 Events Per 100 Participant-Years |
| Dabigatran | Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date | 0.08 Events Per 100 Participant-Years |
| Rivaroxaban | Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date | 0.04 Events Per 100 Participant-Years |
| Edoxaban | Event Rate Per 100 Participant-Years For First Occurrence of Systemic Embolism Events After Index Date | 0.05 Events Per 100 Participant-Years |