Estimation of the effectiveness of apixaban in non valvular atrial fibrillation in anticoagulant suitable population in Argentina

Giorgi,; Caroli, Christian; Micone, Paula; Giglio, Norberto; Aiello, Eleonora; Donato, B.M.K.; Mould, J.F.; Radero, G.; Casas, María Luisa Maestro de las

doi:10.1093/eurheartj/eht309.p3351

Cited by 3 publications

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“…The model estimations using epidemiological data in Argentina also suggested that apixaban relative to warfarin in AF patients could reduce the disease burden and costs, and improve patients’ survival and quality of life. [ 30 ] In Eastern Europe, the Middle East, Africa and Latin America, XANTUS-EL study confirmed low stroke and bleeding risks in AF patients treated with rivaroxaban [ 31 ] ;however, warfarin was not the reference in this study. To date, there are still no observational studies directly focusing on the effect of NOACs versus warfarin in LatAm patients with AF.…”

Section: Discussionmentioning

confidence: 63%

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation

Zhang

et al. 2020

Medicine

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Section: Discussionmentioning

confidence: 63%

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation

Zhang

et al. 2020

Medicine

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“…97 There has been a study showing the potential benefits of apixaban in Latin America, suggesting the use of NOACs in this region may be favorable due to perceived benefits in practice compared to VKA therapy. 98 The more urgent issue that needs to be addressed in the region is the recognition of the value of anticoagulation with VKAs or NOACs in the prevention of stroke, as many physicians do not prescribe these agents appropriately. Therefore, increasing awareness of the need for anticoagulation in patients with AF should be a public health priority in Latin America, facilitating the development of more robust anticoagulation services.…”

Section: Methodsmentioning

confidence: 99%

Stroke Prevention in Atrial Fibrillation: Focus on Latin America

Massaro¹,

Lip²

2016

Arquivos Brasileiros De Cardiologia

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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with an estimated prevalence of 1-2% in North America and Europe. The increased prevalence of AF in Latin America is associated with an ageing general population, along with poor control of key risk factors, including hypertension. As a result, stroke prevalence and associated mortality have increased dramatically in the region. Therefore, the need for effective anticoagulation strategies in Latin America is clear. The aim of this review is to provide a contemporary overview of anticoagulants for stroke prevention.The use of vitamin K antagonists (VKAs, eg, warfarin) and aspirin in the prevention of stroke in patients with AF in Latin America remains common, although around one fifth of all AF patients receive no anticoagulation. Warfarin use is complicated by a lack of access to effective monitoring services coupled with an unpredictable pharmacokinetic profile. The overuse of aspirin is associated with significant bleeding risks and reduced efficacy for stroke prevention in this patient group. The non-VKA oral anticoagulants (NOACbs) represent a potential means of overcoming many limitations associated with VKA and aspirin use, including a reduction in the need for monitoring and a reduced risk of hemorrhagic events.The ultimate decision of which anticoagulant drug to utilize in AF patients depends on a multitude of factors. More research is needed to appreciate the impact of these factors in the Latin American population and thereby reduce the burden of AF-associated stroke in this region.

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Estimation of the cost-effectiveness of apixaban versus vitamin K antagonists in the management of atrial fibrillation in Argentina

et al. 2015

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Apixaban, a novel oral anticoagulant which has been approved for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation, reduces both ischemic and haemorrhagic stroke and produces fewer bleedings than vitamin K antagonist warfarin. These clinical results lead to a decrease in health care resource utilization and, therefore, have a positive impact on health economics of atrial fibrillation. The cost-effectiveness of apixaban has been assessed in a variety of clinical settings and countries. However, data from emergent markets, as is the case of Argentina, are still scarce.We performed a cost-effectiveness analysis of apixaban versus warfarin in non-valvular atrial fibrillation (NVAF) in patients suitable for oral anticoagulation in Argentina. A Markov-based model including both costs and effects were used to simulate a cohort of patients with NVAF. Local epidemiological, resource utilization and cost data were used and all inputs were validated by a Delphi Panel of local experts. We adopted the payer’s perspective with costs expressed in 2012 US Dollars.The study revealed that apixaban is cost-effective compared with warfarin using a willingness to pay threshold ranging from 1 to 3 per capita Gross Domestic Product (11558 – 34664 USD) with an incremental cost-effectiveness ratio of 786.08 USD per QALY gained. The benefit is primarily a result of the reduction in stroke and bleeding events.The study demonstrates that apixaban is a cost-effective alternative to warfarin in Argentina.

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Estimation of the effectiveness of apixaban in non valvular atrial fibrillation in anticoagulant suitable population in Argentina

Cited by 3 publications

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Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation

Stroke Prevention in Atrial Fibrillation: Focus on Latin America

Estimation of the cost-effectiveness of apixaban versus vitamin K antagonists in the management of atrial fibrillation in Argentina

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