title: Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS-ACTS Substudy.
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).
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut. craig.coleman@hhchealth.org.
authors.forename: Craig I
authors.initials: CI
authors.lastname: Coleman
authors.affiliation: Vascular Center, Munich, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Haas
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Alexander G G
authors.initials: AG
authors.lastname: Turpie
authors.affiliation: Global Integrated Analysis, Bayer Pharma AG, Wuppertal, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Kuhls
authors.affiliation: Global Medical Affairs, Bayer Pharma AG, Berlin, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Hess
authors.affiliation: Global Market Access, Bayer Pharma AG, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Evers
authors.affiliation: Department of Neurology and Stroke Center, Paris-Diderot-Sorbonne University, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Amarenco
authors.affiliation: Centre for Cardiovascular Sciences, University of Birmingham and Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom.|Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.affiliation: Cardiovascular and Cell Sciences Research Institute, St George's, University of London, London, United Kingdom.
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D001777:Blood Coagulation / Q000187:drug effects*; D057915:Drug Substitution; D065427:Factor Xa Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012042:Registries; D000069552:Rivaroxaban / Q000008:administration & dosage* / Q000009:adverse effects; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D014812:Vitamin K; D000069552:Rivaroxaban