Prescribing Patterns and Outcomes of Edoxaban in Atrial Fibrillation: One-Year Data from the Global ETNA-AF Program

Autoři: doc. RNDr. Ladislav Pecen, CSc.
Rok vydání: 2023
Typ publikace: Článek v odborném periodiku
Periodikum: Journal of Clinical Medicine
Bibliografická citace: CHAO, T. F., UNVERDORBEN, M., KIRCHHOF, P., KORETSUNE, Y., YAMASHITA, T., CROZIER, R. A., PECEN, Ladislav, CHEN, C., BORROW, A. P., DE CATERINA, R. Prescribing Patterns and Outcomes of Edoxaban in Atrial Fibrillation: One-Year Data from the Global ETNA-AF Program. Journal of Clinical Medicine. 2023, 12(5), 1870. ISSN 2077-0383. E-ISSN 2077-0383
Dostupné z: doi:10.3390/jcm12051870.
DOI: 10.3390/jcm12051870
ID: 571016
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Abstrakt

Non-recommended dosing occurs in ~25–50% of non-vitamin K antagonist oral anticoagulant prescriptions, with limited data for edoxaban. We analyzed edoxaban dosing patterns in atrial fibrillation patients from the Global ETNA-AF program, relating patterns to baseline characteristics and 1-year clinical outcomes. The following dosing groups were compared: non-recommended 60 mg (“overdosed”) vs. recommended 30 mg, non-recommended 30 mg (“underdosed”) vs. recommended 60 mg. Most (22,166/26,823, 82.6%) patients received recommended doses. Non-recommended dosing was more frequent near label-specified dose-reduction thresholds. Ischemic stroke (IS, HR 0.85, 95% CI 0.50–1.47, p = 0.6) and major bleeding (MB, HR 1.47, 95% CI 0.97–2.71, p = 0.07) did not differ between recommended 60 mg and “underdosed” groups, whereas all-cause (HR 1.61, 95% CI 1.23–2.08, p = 0.0003) and cardiovascular deaths (HR 1.61, 95% CI 1.11–2.38, p = 0.01) were higher in the “underdosed” group. Compared with recommended 30 mg, the “overdosed” group had lower IS (HR 0.51, 95% CI 0.28–0.98, p = 0.04) and all-cause death (HR 0.74, 95% CI 0.55–0.98, p = 0.03) without higher MB (HR 0.74, 95% CI 0.46–1.22, p = 0.2). In conclusion: non-recommended dosing was infrequent, but more common near dose-reduction thresholds. “Underdosing” was not associated with better clinical outcomes. The “overdosed” group had lower IS and all-cause death without higher MB.