One in three NOAC users skipping meds

One in three patients prescribed NOACs halt their medication within the first six months of use, increasing their risk of stroke, transient ischaemic attack and death, authors of a study say.

These patients were 75% more likely to have a stroke, TIA or death if they were non-persistent to dabigatran and 89% more likely if they were non-persistent to rivaroxaban, compared with patients who continued their medication.

“Although NOACs are commonly viewed as more effective and convenient replacements for warfarin, NOAC non-persistence in practice may limit the expected benefits,” the study authors wrote.

“Non-persistence” was defined by the researchers as a gap of two weeks or more between prescriptions.

This was considered a clinically meaningful gap in the anticoagulation therapy because both drugs have short half-lives of up to 17 hours, and most patients eliminate 95% or more of the medication within four days.

To study real-world adherence to antithrombotics, the researchers undertook a retrospective cohort study of Canadian prescription data between 1998 and 2014.

Almost 26,000 adults prescribed either dabigatran or rivaroxaban were included in the study.

The US and Canadian researchers found that within six months of drug initiation, one third of patients had gaps of at least a fortnight between their NOAC prescriptions.

In terms of TIA and stroke alone, the risk for dabigatran non-persistence was four times higher, and rivaroxaban non-persistence was six times higher. …>>Read more

Source: Medical Republic

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