Evidence map›Paper›PMID 36725812›Full record

ArticleDrugs - real world outcomes2023

Time Trends in Patient Characteristics of New Rivaroxaban Users with Atrial Fibrillation in Germany and the Netherlands.

Annemarie Voss, Elisabeth Smits, Karin M A Swart, Yanina Balabanova, Gunnar Brobert, Kiliana Suzart-Woischnik, Ron M C Herings, Tania Schink, Ulrike Haug

Open access · goldAbstract read
In one paragraph

Article in Drugs - real world outcomes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 48% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

9 authors at 4 institutions in 2 countries.

Annemarie VossDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.ORCID http://orcid.org/0000-0001-8109-1108
Elisabeth SmitsPHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0003-1882-4748
Karin M A SwartPHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0003-2521-5780
Yanina BalabanovaBayer AG, Berlin, Germany.ORCID http://orcid.org/0000-0002-5065-4788
Gunnar BrobertBayer AB, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-7446-9851
Kiliana Suzart-WoischnikBayer AG, Berlin, Germany.ORCID http://orcid.org/0000-0002-3189-6378
Ron M C HeringsPHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0002-2561-8734
Tania SchinkDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.ORCID http://orcid.org/0000-0002-0224-1866
Ulrike HaugDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. haug@leibniz-bips.de.ORCID http://orcid.org/0000-0002-1886-2923
Pharmo Institute · NLBayer (Germany) · DELeibniz Institute for Prevention Research and Epidemiology - BIPS · DEUniversity of Bremen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUse of the direct oral anticoagulant rivaroxaban has strongly increased in Europe since its market approval for non-valvular atrial fibrillation in 2011. Patients characteristics of rivaroxaban initiators may have changed over time but this has not been investigated so far.

objectiveWe aimed to describe time trends of patient baseline characteristics among new rivaroxaban users with non-valvular atrial fibrillation from 2011 to 2016/17 in two European countries.

methodsWe used data from Germany (German Pharmacoepidemiological Research Database) and the Netherlands (PHARMO Database Network). We included new rivaroxaban users with (i) a first dispensing between 2011 and 2016/17, (ii) ≥ 2 years of age, and (iii) a diagnosis of non-valvular atrial fibrillation and described their baseline medication and comorbidity prior to starting rivaroxaban stratified by year of inclusion.

resultsOverall, 130,652 new rivaroxaban users were included during the study period (Germany: N = 127,743, the Netherlands: N = 2909). The sex ratio and median age remained relatively stable over time. The proportion of patients without prior use of oral anticoagulants before initiation of rivaroxaban increased in both countries between 2011 and 2016/17 (Germany: from 51 to 76%, the Netherlands: from 57 to 85%). In Germany, we observed a relative decrease by 27% in the proportion of new rivaroxaban users with a history of ischemic stroke and by 18% in the proportion with a transient ischemic attack at baseline. No such a pattern was observed in the Netherlands. The proportion of patients with heart failure at baseline showed a three-fold increase in the Netherlands, while there was a relative decrease by 12% in Germany.

conclusionsPatient characteristics of new rivaroxaban users with non-valvular atrial fibrillation changed between 2011 and 2016/17, but changes differed between countries. These patterns have methodological implications. They have to be considered in the interpretation of observational studies comparing effectiveness and safety of oral anticoagulants, especially regarding potential bias due to unmeasured confounding.

Identifiers

PMID36725812
PMCPMC10232386
OpenAlexW4318763937

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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.