European Heart Journal - Cardiovascular Pharmacotherapy, Volume 5, Issue 2, April 2019, Pages 70–79
Dr Camm et al. analysed XANTUS study data and assessed outcomes associated with non-recommended dosing and patient characteristics that may have impacted dose choice. In Europe, the approved rivaroxaban dose for stroke prevention in patients with atrial fibrillation is 20 mg o.d., with 15 mg o.d. recommended in patients with creatinine clearance (CrCl) of 15–49 mL/min. However, non-recommended doses are prescribed in real-world practice. Baseline characteristics and 1-year outcomes were compared in 4464/6784 patients. Multivariable analysis identified age, anaemia, congestive heart failure, diabetes mellitus, CrCl, lower body weight, atrial fibrillation type, and vascular disease as predictors of non-recommended dosing. The authors concluded that non-recommended rivaroxaban dosing was associated with less favourable outcomes. Again, the conclusion was that treatment quality and adherence to guidelines are important.
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