Dr Eric Peterson Explains the Results of Rivaroxaban Adherence Study

At the American College of Cardiology 66^th Scientific Session, Eric Peterson, MD, professor of medicine in the division of cardiology at Duke University School of Medicine and executive director of the Duke Clinical Research Institute, presented study findings that showed patients discontinued rivaroxaban less frequently than other anticoagulation agents. These results are important, he said, because regardless of what a clinician prescribes, “it’s the drugs that patients take that make the difference.”

Transcript (slightly modified)

Who was the study population for your research, and what were the findings?

We studied over 220,000 patients who had atrial fibrillation and looked at their various treatment patterns as well as their adherence to the medicines they were treated with. The major findings were that rivaroxaban, one of the novel oral agents, had higher rates of adherence, proportion of days covered greater than 80%, we found that over 80% of patients were able to take the medicines as prescribed. In contrast, some of the other agents, apixaban and dabigatran, were much lower at 70 to 75%, which was significantly less, and then even lower on those patients who were treated with warfarin.

Why did patients discontinue rivaroxaban less frequently than other anticoagulants?

I think it’s a combination of things, but in part that medicine once a day makes it easier for patients to take and it’s, in addition, well tolerated with regards to bleeding issues.

Why is it important to show that rivaroxaban is not just safe and effective, but also tolerable to patients?

At the end of the day, it’s the drugs that patients take that make the difference. We could order anything we can prescribe to patients, but if they don’t take it on a routine and consistent basis, then in fact the benefits that we expect will not be seen.

How do these findings contribute to the real-world evidence supporting rivaroxaban?

From clinical trials we get efficacy and safety, but from real-world data we get how patients actually take those medications and what it will mean to them long-term. In our study we showed that in fact rivaroxaban is better tolerated, is taken longer and more consistently by patients, which will result ultimately in hopefully better outcomes.