Next Article in Journal
Disparities of Health Service for the Poor in the Coastal Area: Does Universal Health Coverage Reduce Disparities?
Previous Article in Journal
Data Collection Infrastructure for Patient Outcomes in the UK—Opportunities and Challenges for Cell and Gene Therapies Launching
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JMAHP
Volume 7
Issue 1
10.1080/20016689.2019.1574541
jmahp-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Meta-Analysis of Real-World Evidence Comparing Non-Vitamin K Antagonist Oral Anticoagulants with Vitamin K Antagonists for the Treatment of Patients with Non-Valvular Atrial Fibrillation

by
Craig I. Coleman
1,
Jean-Baptiste Briere
2,*,
Laurent Fauchier
3,
Pierre Levy
4,
Kevin Bowrin
5,
Mondher Toumi
6,
Aurélie Millier
7,
Vanessa Taieb
8 and
Olivia Wu
9
1
School of Pharmacy, University of Connecticut, Storrs, CT, USA
2
Health Economist, Bayer AG, Berlin, Germany
3
Cardiologie, Centre Hospitalier Universitaire Trousseau et Université François Rabelais, Tours, France
4
LEDa-LEGOS, Université Paris-Dauphine, PSL ResearchUniversity, Paris, France
5
HEOR CV, Bayer Plc, Reading, UK
6
Faculty of Medicine, University of Aix-Marseille, Marseille, France
7
HEOR Department, HTA Team, Creativ-Ceutical, Paris, France
8
HEOR Department, Evidence Synthesis Team, Creativ-Ceutical, London, UK
9
HEHTA, University of Glasgow, Glasgow, UK
*
Author to whom correspondence should be addressed.
J. Mark. Access Health Policy 2019, 7(1), 1574541; https://doi.org/10.1080/20016689.2019.1574541
Submission received: 4 September 2018 / Revised: 16 January 2019 / Accepted: 18 January 2019 / Published: 4 February 2019

Abstract

Introduction: Numerous real-world studies have compared non-vitamin K antagonist oral anticoagulants (NOACs) with vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation (NVAF). A meta-analysis was performed to synthesize the available evidence. Methods: Systematic searches were performed through 12/2016 to identify non-randomized NVAF studies comparing NOACs with VKAs, and reporting effectiveness, safety, or persistence. Results: Of 562 citations identified, 49, 79, and 18 compared rivaroxaban, dabigatran, and apixaban, respectively, with VKAs and were included. Compared with VKAs, rivaroxaban was associated with a reduced risk of ischemic stroke (IS) (hazard ratio [HR] = 0.83, 95% confidence interval [CI] = 0.75–0.93), intracranial haemorrhage (ICH) (HR = 0.69, 95% CI = 0.52–0.90), and non-persistence (HR = 0.62, 95% CI = 0.60–0.65). Dabigatran was associated with a significantly lower risk of IS (HR = 0.80, 95% CI = 0.65–0.98) and ICH (HR = 0.45, 95% CI = 0.36–0.58), but not for non-persistence (HR = 0.91, 95% CI = 0.53–1.55), compared with VKAs. Apixaban was associated with a lower risk of ICH than VKAs (HR = 0.41, 95% CI = 0.28–0.60), but was not different to VKAs in terms of IS (HR = 1.01, 95% CI = 0.87–1.17) or non-persistence (HR = 1.08, 95% CI = 0.81–1.45). Conclusion: NOACs appear to be at least as effective and safe as VKAs for stroke prevention in patients with NVAF.
Keywords: anticoagulation; non-valvular atrial fibrillation; non-vitamin K antagonist oral anticoagulants; real-world evidence; stroke prevention; meta-analysis anticoagulation; non-valvular atrial fibrillation; non-vitamin K antagonist oral anticoagulants; real-world evidence; stroke prevention; meta-analysis

Share and Cite

MDPI and ACS Style

Coleman, C.I.; Briere, J.-B.; Fauchier, L.; Levy, P.; Bowrin, K.; Toumi, M.; Millier, A.; Taieb, V.; Wu, O. Meta-Analysis of Real-World Evidence Comparing Non-Vitamin K Antagonist Oral Anticoagulants with Vitamin K Antagonists for the Treatment of Patients with Non-Valvular Atrial Fibrillation. J. Mark. Access Health Policy 2019, 7, 1574541. https://doi.org/10.1080/20016689.2019.1574541

AMA Style

Coleman CI, Briere J-B, Fauchier L, Levy P, Bowrin K, Toumi M, Millier A, Taieb V, Wu O. Meta-Analysis of Real-World Evidence Comparing Non-Vitamin K Antagonist Oral Anticoagulants with Vitamin K Antagonists for the Treatment of Patients with Non-Valvular Atrial Fibrillation. Journal of Market Access & Health Policy. 2019; 7(1):1574541. https://doi.org/10.1080/20016689.2019.1574541

Chicago/Turabian Style

Coleman, Craig I., Jean-Baptiste Briere, Laurent Fauchier, Pierre Levy, Kevin Bowrin, Mondher Toumi, Aurélie Millier, Vanessa Taieb, and Olivia Wu. 2019. "Meta-Analysis of Real-World Evidence Comparing Non-Vitamin K Antagonist Oral Anticoagulants with Vitamin K Antagonists for the Treatment of Patients with Non-Valvular Atrial Fibrillation" Journal of Market Access & Health Policy 7, no. 1: 1574541. https://doi.org/10.1080/20016689.2019.1574541

APA Style

Coleman, C. I., Briere, J. -B., Fauchier, L., Levy, P., Bowrin, K., Toumi, M., Millier, A., Taieb, V., & Wu, O. (2019). Meta-Analysis of Real-World Evidence Comparing Non-Vitamin K Antagonist Oral Anticoagulants with Vitamin K Antagonists for the Treatment of Patients with Non-Valvular Atrial Fibrillation. Journal of Market Access & Health Policy, 7(1), 1574541. https://doi.org/10.1080/20016689.2019.1574541

Article Metrics

Back to TopTop