Evidence map›Paper›PMID 34115769›Full record

Observational studyPloS one2021

Real-world safety and effectiveness of rivaroxaban using Japan-specific dosage during long-term follow-up in patients with atrial fibrillation: XAPASS.

Takanori Ikeda, Satoshi Ogawa, Takanari Kitazono, Jyoji Nakagawara, Kazuo Minematsu, Susumu Miyamoto, Yuji Murakawa, Sanghun Iwashiro, Yutaka Okayama, Toshiyuki Sunaya and 2 more

Open access · goldAbstract readObservational StudyMulticenter Study
In one paragraph

Observational study in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 1 country.

Takanori IkedaDepartment of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
Satoshi OgawaInternational University of Health and Welfare, Mita Hospital, Tokyo, Japan.
Takanari KitazonoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jyoji NakagawaraOsaka Namba Clinic, Osaka, Japan.
Kazuo MinematsuNational Cerebral and Cardiovascular Center, Suita, Japan.
Susumu MiyamotoDepartment of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Yuji MurakawaThe 4th Department of Internal Medicine, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki, Japan.
Sanghun IwashiroMedical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan.
Yutaka OkayamaMedical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan.
Toshiyuki SunayaResearch & Development Japan, Bayer Yakuhin, Ltd., Osaka, Japan.
Kazufumi HiranoMedical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan.
Takanori HayasakiMedical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan.
Bayer (Japan) · JPNational Cerebral and Cardiovascular Center · JPKyoto University · JPKyushu University · JPMita Hospital · JPTeikyo University · JPToho University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS) was designed to investigate safety and effectiveness during long-term follow-up of rivaroxaban treatment, using reduced doses compared with other global regions, in Japanese patients with non-valvular atrial fibrillation in real-world clinical practice.

methodsIn this prospective, open-label, single-arm, observational study, 11,308 patients with non-valvular atrial fibrillation newly prescribed rivaroxaban (15/10 mg once daily) at 1416 sites across Japan were enrolled and followed for a mean of 2.5 years.

resultsIn total, 10,664 and 10,628 patients were included in the safety and effectiveness analyses, respectively. In the safety population, mean (standard deviation) age was 73.1 (9.8) years and Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke/TIA (2 points) (CHADS2) score was 2.2 (1.3). Incidences (95% confidence intervals) of any and major bleeding were 3.77 (3.53-4.01) and 1.16 (1.03-1.29) events per 100 patient-years, respectively. Age ≥75 years, creatinine clearance <50 mL/min, diabetes mellitus, and vascular disease were independently associated with incidence of major bleeding. The primary composite effectiveness outcome of stroke, non-central nervous system systemic embolism, and myocardial infarction occurred at an incidence (95% confidence interval) of 1.32 (1.18-1.46) events per 100 patient-years. Age ≥75 years, hypertension, prior ischemic stroke/transient ischemic attack, and concomitant use of antiplatelets were independently associated with incidence of the composite outcome of stroke, non-central nervous system systemic embolism, and myocardial infarction.

conclusionIn the XAPASS, a large-scale study involving a broad range of patients with non-valvular atrial fibrillation newly prescribed rivaroxaban using Japan-specific dosage in real-world clinical practice, no unexpected safety or effectiveness concerns were detected during up to 5 years of follow-up.

Indexed as

Atrial FibrillationFactor Xa InhibitorsRivaroxabanStrokeAgedAged, 80 and overFemaleFollow-Up StudiesHemorrhageHumansJapanMaleMiddle AgedProspective StudiesTreatment OutcomeFactor Xa InhibitorsRivaroxaban

Identifiers

PMID34115769
PMCPMC8195353
OpenAlexW3168107196

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.