82.1% initially diagnosed at stage IV. Common sites of metastasis were bone (41.1%), brain (23.2%), contralateral lung (19.0%), and liver (15.8%). 24.2% were current smokers; 67.4% past (median 38 pack years). There were no differences in these characteristics by regimen. The most common comorbidities were COPD (30.5%) and diabetes (16.8%). Most patients were from the South (56.8%) vs. Northeast (13.7%), Midwest (21.1%), and West (8.4%). Patients from the South were 3 times as likely (OR = 3.02) to receive a bevacizumab-containing regimen (Regimens B+D) than patients from the non-South regions, χ 2 = 6.5293, df = 1, p = 0.0106. ConClusions: Patients treated for advanced NSCLC in real world settings appear demographically and clinically similar to patients treated in clinical trials. Preliminary findings suggest regional differences in chemotherapeutic treatment patterns.

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Aims  Vascular calcification is common in diabetic patients. Warfarin has been associated with renovascular calcification and worsening renal function; rivaroxaban may provide renopreservation by decreasing vascular inflammation. We compared the impact of rivaroxaban and warfarin on renal outcomes in diabetic patients with non-valvular atrial fibrillation (NVAF). Methods and results  Using United States IBM MarketScan data from January 2011 to December 2017, we identified adults with both NVAF and diabetes, newly-initiated on rivaroxaban or warfarin with ≥12-month insurance coverage prior to anticoagulation initiation. Patients with Stage 5 chronic kidney disease (CKD) or undergoing haemodialysis at baseline were excluded. Differences in baseline covariates between cohorts were adjusted using inverse probability-of-treatment weighting (IPTW) based on propensity scores (absolute standardized differences <0.1 achieved for all after adjustment). Outcomes included incidence rates of emergency department/hospital admissions for acute kidney injury (AKI) and the composite of the development of Stage 5 CKD or need for haemodialysis. Patients were followed until an event, index anticoagulant discontinuation/switch, insurance disenrollment, or end-of-data availability. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox regression. We assessed 10 017 rivaroxaban (22.6% received a reduced dose) and 11 665 warfarin users. In comparison to warfarin, rivaroxaban was associated with lower risks of AKI (HR = 0.83, 95% CI = 0.74–0.92) and development of Stage 5 CKD or need for haemodialysis (HR = 0.82, 95% CI = 0.70–0.96). Sensitivity and subgroup analyses had similar effects as the base-case analysis. Conclusion  Rivaroxaban appears to be associated with lower risks of undesirable renal outcomes vs. warfarin in diabetic NVAF patients.

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.