The Changing Face of Venous Thromboembolism Management in England

Ramagopalan, Sreeram; Carroll, Robert; Ulvestad, Maria; Mehmud, Faisal; Alikhan, Raza

doi:10.2217/fca-2019-0003

Cited by 4 publications

(2 citation statements)

References 8 publications

(16 reference statements)

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“…6 , 7 Real-world data can provide a greater understanding of the current treatment landscape for VTE and are important for furthering our understanding of how anticoagulants are prescribed and used in clinical practice. 8 Real-world studies that have compared the use of DOACs with other anticoagulation therapies in VTE populations have primarily been conducted in Europe [9][10][11][12] and North America, 13 with only limited studies in the Scandinavian setting. 14 , 15 The patient registries in Scandinavia are regarded as valuable sources of real-world data because of their nationwide coverage and high completeness.…”

Section: Introductionmentioning

confidence: 99%

Oral Anticoagulation Therapy for Venous Thromboembolism in Norway: Time Trends and Treatment Patterns

Ghanima

Schultze

Donaldson

et al. 2021

Clinical Therapeutics

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Purpose: Data describing treatment patterns of patients with venous thromboembolism (VTE) patients in Scandinavia are scarce. This study sought to address this scarcity by describing demographic and clinical characteristics, trends in the use of oral anticoagulants (OACs), and treatment patterns in patients treated for VTE in Norway between 2013 and 2017.Methods: Using data from Norway's nationwide registries, a cohort study included patients newly (after 2008) treated OACs who were diagnosed with VTE between January 2013 and December 2017 and were dispensed an OAC (warfarin, apixaban, rivaroxaban, dabigatran, or edoxaban) within 30 days. Patient characteristics and the percentage of patients with VTE who initiated treatment with each OAC for each calendar year were reported. Initial therapy persistence was assessed using Kaplan-Meier curves and compared between the OAC groups using the log-rank test.Findings: The comorbidity burden was similar between patients taking warfarin and those taking apixaban but lower among patients taking rivaroxaban. Direct oral anticoagulant (DOAC) use increased from 33.2% to 93.6% during the study period, whereas warfarin use decreased. Persistence was higher in the apixaban cohort compared with the warfarin cohort, with the difference mostly apparent after 6 months, whereas persistence was similar between the patients taking rivaroxaban and those taking warfarin.Implications: Between 2013 and 2017, DOAC use among patients with VTEs increased markedly in Norway, whereas the use of warfarin decreased. Patients taking apixaban had higher persistence compared with those taking warfarin, whereas patients taking warfarin and those taking rivaroxaban had similar persistence. Further studies with longer followup are required to examine the use of extended OAC treatment for VTE. ( Clin Ther. 2021;000:1-12.

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Section: Introductionmentioning

confidence: 99%

Oral Anticoagulation Therapy for Venous Thromboembolism in Norway: Time Trends and Treatment Patterns

Ghanima

Schultze

Donaldson

et al. 2021

Clinical Therapeutics

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“…1 Since 2016, rivaroxaban has been the most common oral anticoagulant prescribed to patients in England with incident VTE. 2 Approval of rivaroxaban for VTE indications was based on data from randomized controlled trials (RCTs) [3][4][5] with strict inclusion/exclusion criteria. Thus far, data on the effectiveness of rivaroxaban for VTE indications among the broad spectrum of patients receiving the drug in routine clinical practice have come from patient registry 6,7 or claims database studies, 8 or observational field studies.…”

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confidence: 99%

Validation of venous thromboembolism diagnoses in patients receiving rivaroxaban or warfarin in The Health Improvement Network

Ruigómez

Brobert²,

Vora

et al. 2020

Pharmacoepidemiology and Drug

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PurposeTo describe the effect that validation of venous thromboembolism (VTE) coded entries in the health improvement network (THIN) has on incidence rates of VTE among a cohort of rivaroxaban/warfarin users.MethodsAmong 36 701 individuals with a first prescription for rivaroxaban/warfarin between 2012 and 2015, we performed a two‐step VTE case identification process followed by a two‐step case validation process involving manual review of patient records. A valid case required a coded entry for VTE at some point after their first rivaroxaban/warfarin prescription with evidence of referral/hospitalization either as a coded entry or entered as free text. Positive predictive values (PPVs) with 95% confidence intervals (CIs) were calculated using validated cases as the gold standard. Incidence rates were calculated per 1000 person‐years with 95% CIs.ResultsWe identified 2166 patients with a coded entry of VTE after their initial rivaroxaban/warfarin prescription; incidence rate of 45.31 per 1000 person‐years (95% CI: 43.49‐47.22). After manual review of patient records including the free text, there were 712 incident VTE cases; incidence rate of 14.90 per 1000 person‐years (95% CI: 13.85‐16.02). The PPV for coded entries of VTE alone was 32.9%, and the PPV for coded entries of VTE with a coded entry of referral/hospitalization was 39.8%; this increased to 69.6% after manual review of coded clinical entries in patient records.ConclusionsAmong rivaroxaban/warfarin users in THIN, valid VTE case identification requires manual review of patient records including the free text to prevent outcome misclassification and substantial overestimation of VTE incidence rates.

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Acceptance of a potential major bleeding among patients with venous thromboembolism on long-term oral anticoagulation: the knowledge of the disease and therapy matters

Konieczyńska

Kupis

Bijak

et al. 2020

Thrombosis Research

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The Changing Face of Venous Thromboembolism Management in England

Cited by 4 publications

References 8 publications

Oral Anticoagulation Therapy for Venous Thromboembolism in Norway: Time Trends and Treatment Patterns

Oral Anticoagulation Therapy for Venous Thromboembolism in Norway: Time Trends and Treatment Patterns

Validation of venous thromboembolism diagnoses in patients receiving rivaroxaban or warfarin in The Health Improvement Network

Acceptance of a potential major bleeding among patients with venous thromboembolism on long-term oral anticoagulation: the knowledge of the disease and therapy matters

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