Present profiles of novel anticoagulant use in Japanese patients with atrial fibrillation: insights from the Rivaroxaban Postmarketing Surveillance Registry

J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):2520-2526. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.006. Epub 2014 Sep 20.

Abstract

Background: The postmarketing surveillance registry evaluated the safety and efficacy of rivaroxaban in Japanese patients with atrial fibrillation (AF) treated with rivaroxaban.

Methods: A total of 10,038 patients with AF were enrolled between April 18, 2012 and December 16, 2013. Overall, 48.9% of the patients were of 75 years or older. The median CHADS2 score was 2 (interquartile range, 1-3). A total of 54.7% of patients had switched from an anticoagulant/antiplatelet drug, whereas 45.3% were treatment naive. Initial analysis was conducted for the 1039 patients who had completed the 6-month follow-up examinations by the end of June 2013. The low dose (10 mg/d) of rivaroxaban had been selected for approximately one quarter of the patients because of bleeding risks and advanced age in addition to renal impairment, although the high dose (15 mg/d) should have been selected.

Results: Major and nonmajor clinically relevant bleeding events were observed in 36 of 1035 patients. Five of 16 patients who concomitantly used 2 or more antiplatelet agents developed a bleeding event. Bleeding events were observed in 8 of 158 patients who were of 75 years or older and weighed 50 kg or less. The composite end point event of stroke, systemic embolism, or myocardial infarction was observed in 6 of 1034 patients.

Conclusions: This registry will continue to provide insights into the safety and efficacy of rivaroxaban in real-world practice.

Keywords: Atrial fibrillation; Japanese; multicenter registry; oral anticoagulation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Asian People
  • Atrial Fibrillation / complications*
  • Embolism / etiology
  • Embolism / prevention & control
  • Female
  • Follow-Up Studies
  • Hemorrhage / chemically induced
  • Hemorrhage / epidemiology
  • Humans
  • Kidney / drug effects
  • Male
  • Middle Aged
  • Morpholines / administration & dosage
  • Morpholines / adverse effects*
  • Morpholines / therapeutic use
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Product Surveillance, Postmarketing*
  • Registries
  • Risk Factors
  • Rivaroxaban
  • Stroke / etiology
  • Stroke / prevention & control
  • Thiophenes / administration & dosage
  • Thiophenes / adverse effects*
  • Thiophenes / therapeutic use
  • Treatment Outcome

Substances

  • Anticoagulants
  • Morpholines
  • Platelet Aggregation Inhibitors
  • Thiophenes
  • Rivaroxaban