Effectiveness and Safety of Different Rivaroxaban Dosage Regimens in Patients with Non-Valvular Atrial Fibrillation: A Nationwide, Population-Based Cohort Study

Scientific Reports
Hsin-Yi HuangChi-Chuan Wang

Abstract

The objective of this study is to evaluate the effectiveness of different rivaroxaban dosage regimens in preventing ischemic stroke and systemic thromboembolism among Asians. A retrospective cohort study was conducted on data from nationwide insurance claims in Taiwan. Patients with non-valvular atrial fibrillation under warfarin or rivaroxaban therapy were included. Propensity score matching was used to balance the covariates, and Cox-proportional hazard models were applied to compare the effectiveness and safety of each treatment group. Rivaroxaban was associated with a significantly lower risk of venous thromboembolism (hazard ratio [HR]: 0.51; 95% confidence interval [CI]: 0.29-0.92, P = 0.02) and intracranial hemorrhage (HR: 0.48; 95% CI: 0.32-0.72, P < 0.001) than warfarin. Rivaroxaban 20 mg and 15 mg were associated with a significantly lower risk of ischemic stroke (20 mg, HR: 0.48; CI: 0.29-0.80, P = 0.005; 15 mg, HR: 0.69; CI: 0.53-0.90, P = 0.005), but rivaroxaban 10 mg was not. In the subgroup analysis of patients older than 65 years, the results were generally the same, except that rivaroxaban had a significantly lower risk of ischemic stroke than warfarin.

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Citations

Mar 28, 2019·Stroke; a Journal of Cerebral Circulation·So-Ryoung LeeGregory Y H Lip
Aug 4, 2019·Clinical Pharmacology and Therapeutics·Shin-Yi LinJiann-Shing Jeng
May 29, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Wanwarang WongcharoenArintaya Phrommintikul

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