Study of Rivaroxaban Use and Potential Adverse Outcomes in Routine Clinical Practice (Sweden)

NCT02468102 | Completed

• 2 other identifiers: 17543XA1405SE
• Study Type: observational
• Target: 99,999
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective cohort study will provide information about: Characteristics of Rivaroxaban use in patients who are prescribed Rivaroxaban for the first time compared to patients who are prescribed standard of care for the first time. The occurrence of intracranial haemorrhage, gastrointestinal and urogenital bleeding, and the occurrence of non-infective liver disease.

Conditions

Acute Coronary Syndrome; Venous Thrombosis; Pulmonary Embolism; Atrial Fibrillation

Keywords

Rivaroxaban; Venous Thrombosis/Pulmonary Embolism; Stroke Prevention in Atrial Fibrillation; Anticoagulants; Hematologic Agents; Therapeutic Uses; Observational; Pulmonary Embolism; Venous Thrombosis; Venous Thromboembolism; Intracranial Hemorrhages; Gastrointestinal Hemorrhage

Outcome Measures

Primary Outcomes (2)

• Descriptive analysis of demographic and clinical characteristics of patients who are prescribed oral rivaroxaban for the first time in comparison with those who are prescribed standard of care for the first time

  The following data will be collected and assessed at 2 and 4 years after rivaroxaban market authorization: • age and sex distribution at index date • dose of rivaroxaban at index date • diagnosis associated with the prescribing of the index drug • use of specific prescribed medications confirming ACS indication • use of other prescribed medications • comorbidity based on diagnoses • renal impairment • healthcare utilization (e.g. outpatient visits and hospital admissions)

  up to 4 years

• Safety and effectiveness: occurrence of hospitalization for a) intracranial haemorrhage, (b) gastrointestinal bleeding, (c) urogenital bleeding among users of rivaroxaban in comparison with individuals receiving current standard of care

  The two cohorts will be followed up from the index date until 12 months after the end of the enrolment period for potential outcomes For descriptive purposes, annualized crude incidence rates of the major bleeding events will be calculated, accompanied by 95% confidence intervals. For evaluation of safety and effectiveness outcome events, Cox proportional hazards regression model will be used. Propensity score matching will be done to account for confounding by indication.

  up to 5 years

Secondary Outcomes (4)

• Occurrence of hospitalization for bleeding events not specified as primary safety outcomes ("other bleeding", secondary safety outcome) in individuals receiving rivaroxaban, in comparison with those receiving current standard of care.

  at 5 years

• Occurrence of non-infective liver disease (secondary safety outcome) in individuals receiving rivaroxaban in comparison with those receiving current standard of care.

  at 5 years

• Outcomes related to effectiveness (DVT/PE, ischaemic stroke or myocardial infarction) in individuals receiving rivaroxaban in comparison with those receiving current standard of care.

  at 5 years

• All-cause mortality as well as cause-specific mortality.

  at 5 years

Study Arms (2)

Rivaroxaban / Cohort 1

Patients who have filled a prescription for rivaroxaban in any pharmacy in Sweden during the study period.

Drug: Rivaroxaban (Xarelto, BAY59-7939)

Standard of care drugs / Cohort 2

Patients who have filled a prescription for standard of care drugs (warfarin, aspirin, clopidogrel, ticlopidine, prasugrel or ticagrelor) in any pharmacy in Sweden during the study period.

Drug: Standard of care drugs

Interventions

Rivaroxaban (Xarelto, BAY59-7939) DRUG

Treatment of deep vein thrombosis (DVT) or pulmonary embolism (PE), and prevention of recurrent DVT and PE (15 mg rivaroxaban twice daily \[bid\] for 3 weeks, then 15 mg or 20 mg once daily \[od\], tablets). Prevention of stroke and systemic embolism with non-valvular atrial fibrillation (stroke prevention in atrial fibrillation \[SPAF\]) with one or more risk factors, prior stroke or transient ischaemic attack (20 mg rivaroxaban \[od\], tablets). Prevention of venous thromboembolism (VTE) in patients undergoing elective hip or knee replacement surgery (recommended dose: 10 mg rivaroxaban \[od\] tablets for 35 days following hip replacement surgery and 14 days following knee replacement surgery). Co-administered with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel or ticlopidine, for the prevention of atherothrombotic events in patients after an acute coronary syndrome (ACS) with elevated cardiac biomarkers (recommended dose 2.5 mg rivaroxaban tablets \[bid\]).

Rivaroxaban / Cohort 1

Standard of care drugs DRUG

For DVT/PE treatment and SPAF, standard of care is treatment with the most widely used vitamin K antagonist, phenprocoumon, and for the secondary prevention of ACS, standard of care is antiplatelet drug(s) such as low-dose acetylsalicylic acid, clopidogrel, dipyridamole, prasugrel, ticlopidine and ticagrelor.

Standard of care drugs / Cohort 2

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Residents of Sweden: The study population will be identified using data from the Swedish national health registers that are maintained by the national Board of Health and Welfare.

You may qualify if:

• All male and female patients who have filled a prescription for rivaroxaban, warfarin, aspirin, clopidogrel, ticlopidine, prasugrel and ticagrelor in any pharmacy in Sweden, between December 9, 2011 and December 31, 2018

You may not qualify if:

• \- For the AF and DVT/PE treatment indications, patients who have filled a prescription for warfarin or another oral anticoagulant at any time between July 1, 2005 and December 9, 2011 will be excluded

Sponsors & Collaborators

• Bayer: lead
• Janssen Scientific Affairs, LLC: collaborator

Study Sites (1)

Many Locations

Multiple Locations, Sweden

Location

Related Links

• Click here to find results for studies related to Bayer products

MeSH Terms

Conditions

Acute Coronary Syndrome; Venous Thrombosis; Pulmonary Embolism; Atrial Fibrillation; Venous Thromboembolism; Intracranial Hemorrhages; Gastrointestinal Hemorrhage

Interventions

Rivaroxaban

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Thrombosis; Embolism and Thrombosis; Lung Diseases; Respiratory Tract Diseases; Embolism; Arrhythmias, Cardiac; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Thromboembolism; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Hemorrhage; Gastrointestinal Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Thiophenes; Sulfur Compounds; Organic Chemicals; Morpholines; Oxazines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Study Officials

• Bayer Study Director

  Bayer

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 8, 2015
• First Posted: June 10, 2015
• Study Start: June 15, 2015
• Primary Completion: December 31, 2018
• Study Completion: September 30, 2020
• Last Updated: September 27, 2021

Record last verified: 2021-09

Locations

SE (1)