Open AccessImpact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS‐ACTS Substudy
Author(s) -
Coleman Craig I.,
Haas Sylvia,
Turpie Alexander G.G.,
Kuhls Silvia,
Hess Susanne,
Evers Thomas,
Amarenco Pierre,
Kirchhof Paulus,
Camm A. John
Publication year - 2016
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22565
Subject(s) - rivaroxaban , medicine , vitamin k antagonist , atrial fibrillation , stroke (engine) , cohort , patient satisfaction , prospective cohort study , warfarin , surgery , mechanical engineering , engineering
ABSTRACT Background The efficacy, safety, and ease of use of rivaroxaban may reduce anticoagulation‐treatment burden and improve nonvalvular atrial fibrillation (NVAF) patient satisfaction compared with vitamin K antagonists (VKAs). Hypothesis Transitioning from a VKA to rivaroxaban improves treatment satisfaction in routine practice. Methods Xarelto for Prevention of Stroke in Patients With Atrial Fibrillation (XANTUS) is a prospective, noninterventional study in patients with NVAF prescribed rivaroxaban for prevention of stroke in routine practice. Patients receiving a VKA 4 weeks prior to the initial XANTUS study visit and switched to rivaroxaban were asked to complete the Anti‐Clot Treatment Scale (ACTS). Changes from the initial visit to the first follow‐up visit at ∼ 3 months (corresponding to a comparison of rivaroxaban vs prior VKA) for ACTS burden and benefit scores were calculated using and reported as least squared mean differences (LSMDs) with 95% confidence intervals (CIs). Results The study included 1291 NVAF patients with prior VKA treatment. The mean baseline ACTS burden and benefit scores were 50.51 ± 8.42 and 10.30 ± 2.70, respectively. After ∼ 3 months of rivaroxaban treatment, LSMDs were 4.38 points (95% CI: 2.53‐6.22, P < 0.0001) for the burden and 1.01 points (95% CI: 0.27‐1.75, P = 0.0075) for the benefit score. Fifty‐four percent and 48% of patients reported experiencing at least a minimally important clinical difference in burden and benefit scores, respectively. Conclusions Within this XANTUS cohort, switching from a VKA to rivaroxaban yielded statistically and clinically significant improvements in ACT burden and benefit scores.