title: Doses of apixaban and rivaroxaban prescribed in real-world United States cardiology practices compared to registration trials.
abstract: Using an I.M.S. LifeLink dataset (19 September 2014-11 September 2015), we compared U.S. cardiologist prescribing of the reduced dose of apixaban (2.5 mg) or rivaroxaban (15 mg) to utilization in their corresponding nonvalvular atrial fibrillation registration randomized trials. Of all prescriptions written by cardiologists for these agents, 20.8% of apixaban and 21.7% of rivaroxaban prescriptions were for a reduced dose; corresponding to a 4.4-fold (16.1% absolute) increase in the use of reduced dose apixaban and a 3% relative (0.6% absolute) increase in reduced dose rivaroxaban use vs. their respective registration trials. Further research is needed to better understand appropriate dosing of patients with novel anticoagulants.
authors.affiliation: a University of Connecticut/Hartford Hospital Health Outcomes, Policy and Evidence Synthesis Group , Hartford , CT , U.S.A. ;
authors.forename: Elaine
authors.initials: E
authors.lastname: Nguyen
authors.affiliation: a University of Connecticut/Hartford Hospital Health Outcomes, Policy and Evidence Synthesis Group , Hartford , CT , U.S.A. ;|b Department of Pharmacy Practice , University of Connecticut School of Pharmacy , Storrs , CT , U.S.A. ;
authors.forename: C Michael
authors.initials: CM
authors.lastname: White
authors.affiliation: c Division of Cardiovascular Medicine , Duke University Medical Center, Duke Clinical Research Institute , Durham , NC , U.S.A. ;
authors.forename: Manesh R
authors.initials: MR
authors.lastname: Patel
authors.affiliation: d Janssen Scientific Affairs L.L.C. , Raritan , NJ , U.S.A. ;
authors.forename: Larry E
authors.initials: LE
authors.lastname: Fields
authors.affiliation: e Department of Emergency Medicine , Baylor College of Medicine , Houston , TX , U.S.A.
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.affiliation: d Janssen Scientific Affairs L.L.C. , Raritan , NJ , U.S.A. ;
authors.forename: Concetta
authors.initials: C
authors.lastname: Crivera
authors.affiliation: a University of Connecticut/Hartford Hospital Health Outcomes, Policy and Evidence Synthesis Group , Hartford , CT , U.S.A. ;|b Department of Pharmacy Practice , University of Connecticut School of Pharmacy , Storrs , CT , U.S.A. ;
authors.forename: Craig I
authors.initials: CI
authors.lastname: Coleman
mesh_terms: D001281:Atrial Fibrillation / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D065427:Factor Xa Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D010818:Practice Patterns, Physicians'; D011720:Pyrazoles / Q000008:administration & dosage* / Q000627:therapeutic use; D011728:Pyridones / Q000008:administration & dosage* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000069552:Rivaroxaban / Q000008:administration & dosage* / Q000627:therapeutic use; D014481:United States
chemical_list: D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D000069552:Rivaroxaban
keywords: Apixaban; Atrial fibrillation; Drug prescriptions; Inappropriate prescribing; Practice patterns, physicians’