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Label Adherence for Non-Vitamin K Antagonist Oral Anticoagulants in a Prospective Cohort of Asian Patients with Atrial Fibrillation
DC Field | Value | Language |
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dc.contributor.author | 엄재선 | - |
dc.contributor.author | 정보영 | - |
dc.date.accessioned | 2019-05-29T05:27:53Z | - |
dc.date.available | 2019-05-29T05:27:53Z | - |
dc.date.issued | 2019 | - |
dc.identifier.issn | 0513-5796 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/169612 | - |
dc.description.abstract | PURPOSE: Label adherence for non-vitamin K antagonist oral anticoagulants (NOACs) has not been well evaluated in Asian patients with non-valvular atrial fibrillation (AF). The present study aimed to assess label adherence for NOACs in a Korean AF population and to determine risk factors of off-label prescriptions of NOACs. MATERIALS AND METHODS: In this COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, patients with AF who were prescribed NOACs between June 2016 and May 2017 were included. Four NOAC doses were categorized as on- or off-label use according to Korea Food and Drug Regulations. RESULTS: We evaluated 3080 AF patients treated with NOACs (dabigatran 27.2%, rivaroxaban 23.9%, apixaban 36.9%, and edoxaban 12.0%). The mean age was 70.5±9.2 years; 56.0% were men; and the mean CHA₂DS₂-VASc score was 3.3±1.4. Only one-third of the patients (32.7%) was prescribed a standard dose of NOAC. More than one-third of the study population (n=1122, 36.4%) was prescribed an off-label reduced dose of NOAC. Compared to those with an on-label standard dosing, patients with an off-label reduced dose of NOAC were older (≥75 years), women, and had a lower body weight (≤60 kg), renal dysfunction (creatinine clearance ≤50 mL/min), previous stroke, previous bleeding, hypertension, concomitant dronedarone use, and anti-platelet use. CONCLUSION: In real-world practice, more than one-third of patients with NOAC prescriptions received an off-label reduced dose, which could result in an increased risk of stroke. Considering the high risk of stroke in these patients, on-label use of NOAC is recommended. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Yonsei University | - |
dc.relation.isPartOf | YONSEI MEDICAL JOURNAL | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Administration, Oral | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Anticoagulants/administration & dosage* | - |
dc.subject.MESH | Anticoagulants/therapeutic use* | - |
dc.subject.MESH | Asian Continental Ancestry Group* | - |
dc.subject.MESH | Atrial Fibrillation/complications | - |
dc.subject.MESH | Atrial Fibrillation/drug therapy* | - |
dc.subject.MESH | Dabigatran/administration & dosage | - |
dc.subject.MESH | Dabigatran/therapeutic use | - |
dc.subject.MESH | Drug Labeling* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Medication Adherence* | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Prospective Studies | - |
dc.subject.MESH | Pyrazoles/therapeutic use | - |
dc.subject.MESH | Pyridines/therapeutic use | - |
dc.subject.MESH | Pyridones/therapeutic use | - |
dc.subject.MESH | Republic of Korea | - |
dc.subject.MESH | Risk Factors | - |
dc.subject.MESH | Rivaroxaban/administration & dosage | - |
dc.subject.MESH | Rivaroxaban/therapeutic use | - |
dc.subject.MESH | Thiazoles/therapeutic use | - |
dc.subject.MESH | Vitamin K/antagonists & inhibitors* | - |
dc.title | Label Adherence for Non-Vitamin K Antagonist Oral Anticoagulants in a Prospective Cohort of Asian Patients with Atrial Fibrillation | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | So-Ryoung Lee | - |
dc.contributor.googleauthor | Young Soo Lee | - |
dc.contributor.googleauthor | Ji-Suck Park | - |
dc.contributor.googleauthor | Myung-Jin Cha | - |
dc.contributor.googleauthor | Tae-Hoon Kim | - |
dc.contributor.googleauthor | Junbeom Park | - |
dc.contributor.googleauthor | Jin-Kyu Park | - |
dc.contributor.googleauthor | Jung-Myung Lee | - |
dc.contributor.googleauthor | Ki-Woon Kang | - |
dc.contributor.googleauthor | Jaemin Shim | - |
dc.contributor.googleauthor | Jae-Sun Uhm | - |
dc.contributor.googleauthor | Jun Kim | - |
dc.contributor.googleauthor | Changsoo Kim | - |
dc.contributor.googleauthor | Jin-Bae Kim | - |
dc.contributor.googleauthor | Hyung Wook Par | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.contributor.googleauthor | Eue-Keun Choi | - |
dc.identifier.doi | 10.3349/ymj.2019.60.3.277 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A03609 | - |
dc.relation.journalcode | J02813 | - |
dc.identifier.eissn | 1976-2437 | - |
dc.identifier.pmid | 30799590 | - |
dc.subject.keyword | Atrial fibrillation | - |
dc.subject.keyword | dose | - |
dc.subject.keyword | drug labeling | - |
dc.subject.keyword | non-vitamin K antagonist oral anticoagulant | - |
dc.contributor.alternativeName | Uhm, Jae Sun | - |
dc.contributor.affiliatedAuthor | 엄재선 | - |
dc.contributor.affiliatedAuthor | 정보영 | - |
dc.citation.volume | 60 | - |
dc.citation.number | 3 | - |
dc.citation.startPage | 277 | - |
dc.citation.endPage | 284 | - |
dc.identifier.bibliographicCitation | YONSEI MEDICAL JOURNAL, Vol.60(3) : 277-284, 2019 | - |
dc.identifier.rimsid | 62593 | - |
dc.type.rims | ART | - |
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