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Moser J, Unverdorben M, Wang CC, Bruggenjurgen B, Lee BC, Chen C, Pecen L, Yamashita T, De Caterina R, Kirchhof P. Effectiveness and safety of edoxaban in 27,333 patients from ETNA-AF with and without a history of intracranial haemorrhage after 2 years of treatment. Europace 2022. [DOI: 10.1093/europace/euac053.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): This study was sponsored by Daiichi Sankyo, Inc. Medical writing and editorial support were provided by Atreju Lackey, PhD of AlphaBioCom, LLC, and funded by Daiichi Sankyo, Inc.
Background/Introduction
Once-daily edoxaban significantly reduced the risk of intracranial haemorrhage (ICH) compared with well-managed warfarin in atrial fibrillation (AF) patients in the ENGAGE AF-TIMI 48 trial. The effectiveness and safety of edoxaban in patients with prior ICH is unknown.
Purpose
To compare the effectiveness and safety of edoxaban in AF patients with or without a history of ICH.
Methods
The Global ETNA-AF programme is composed of and, thus, integrates data from multiple prospective, observational, and noninterventional regional studies collecting data of AF patients treated with edoxaban for stroke prevention. This snapshot analysis presents global and regional baseline characteristics with medical history and 2-year annualised rates of all-cause mortality, stroke (haemorrhagic, ischaemic, any), and bleeding (major bleeding [MB] including ICH, clinically relevant nonmajor bleeding [CRNMB], any bleeding), in patients with or without ICH history.
Results
Overall, 27,333 patients from Europe, Japan, South Korea, and Taiwan were analysed, including 367 with prior ICH and 26,966 without prior ICH. There were proportionally fewer patients with a history of ICH in the European population. Patients with a history of ICH were older (P=0.006), had a lower body mass index (P<0.0001), had a lower creatinine clearance (P=0.0001), and had more comorbidities, with a higher percentage of patients with a history of stroke, transient ischaemic attack (TIA), or MB (Table 1); the higher level of comorbidities noted in patients with a history of ICH was also reflected by higher baseline CHA2DS2-VASc and HAS-BLED scores (Table 1). Patients with a history of ICH were more likely receiving 30 mg edoxaban at baseline, whereas patients without ICH history were more often on 60 mg edoxaban (each P<0.0001). In patients with vs without ICH history, all-cause mortality (5.10% vs 3.14%; P=0.01), ischaemic stroke (1.79% vs 0.73%; P=0.006), and any stroke rates (3.25% vs 0.95%; P<0.0001) were higher (Table 2). Patients with vs without ICH history had higher annualised rates of MB (2.50% vs 1.00%; P=0.001), ICH (1.42% vs 0.27%; P<0.0001), haemorrhagic stroke (1.42% vs 0.20%; P<0.0001), CRNMB (2.49% vs 1.40%; P=0.04), and any bleeding (7.57% vs 4.27%; P=0.001), but these rates were low compared to other high-risk populations. ICH was not selected as a predictor of cardiovascular outcomes on multivariate prediction modelling. ICH had non-significant effects in predicting all-cause death (HR 1.22), ischemic stroke (HR 1.14), and major bleeding (HF 1.37) and repeat ICH (HR 1.94).
Conclusions
Patients with a history of ICH are a small, elderly, multimorbid subgroup of patients with AF. Treatment with the non-vitamin K antagonist oral anticoagulant edoxaban resulted in relatively low rates of major events.
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Affiliation(s)
- J Moser
- University Heart Centre Hamburg, Department of Cardiology, Hamburg, Germany
| | - M Unverdorben
- Daiichi Sankyo, Inc., Basking Ridge, United States of America
| | - CC Wang
- Linkou Chang Gung Memorial Hospital and Chang Gung University, Division of Cardiology, Department of Internal Medicine, Taoyuan, Taiwan
| | - B Bruggenjurgen
- Steinbeis-University, Institute for Health Economics, Berlin, Germany
| | - BC Lee
- Hallym University Sacred Heart Hospital, Department of Neurology, Anyang, Korea (Republic of)
| | - C Chen
- Daiichi Sankyo, Inc., Basking Ridge, United States of America
| | - L Pecen
- Institute of Computer Science ASCR, Prague, Czechia
| | - T Yamashita
- Cardiovascular Institute, Department of Cardiovascular Medicine, Tokyo, Japan
| | - R De Caterina
- University of Pisa, Department of Surgery, Medical, Molecular and Critical Area Pathology, Pisa, Italy
| | - P Kirchhof
- University Heart Centre Hamburg, Department of Cardiology, Hamburg, Germany
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De Caterina R, Bruggenjurgen B, Kim YH, Koretsune Y, Lee BC, Levy P, Yamashita T, Wang CC, Kirchhof P. P4803Prior antithrombotic therapy: a snapshot of 17,769 patients from the global edoxaban treatment in routine clinical practice in patients with non-valvular atrial fibrillation programme (global ETNA-AF). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R De Caterina
- Università degli Studi “G. D'Annunzio”, Institute of Cardiology, Chieti, Italy
| | - B Bruggenjurgen
- Institute for Health Economics, Steinbeis-University, Berlin, Germany
| | - Y.-H Kim
- Korea University College of Medicine and Korea University Medical Center, Department of Internal Medicine, Seoul, Korea Republic of
| | - Y Koretsune
- Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - B.-C Lee
- Hallym University Sacred Heart Hospital, Anyang-Si, Gyeonggi-Do, Korea Republic of
| | - P Levy
- Université Paris-Dauphine, PSL Research University, LEDa [LEGOS], Paris, France
| | | | - C.-C Wang
- Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ROC
| | - P Kirchhof
- University of Birmingham, School of Clinical and Experimental Medicine, Birmingham, United Kingdom
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De Caterina R, Bruggenjurgen B, Kim YH, Koretsune Y, Lee BC, Levy P, Yamashita T, Wang CC, Kirchhof P. P2886Baseline stroke and bleeding risks in the global edoxaban treatment in routine clinical practice in patients with non-valvular atrial fibrillation programme (global ETNA-AF): first snapshot analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R De Caterina
- Università degli Studi “G. D'Annunzio”, Institute of Cardiology, Chieti, Italy
| | - B Bruggenjurgen
- Institute for Health Economics, Steinbeis-University, Berlin, Germany
| | - Y.-H Kim
- Korea University College of Medicine and Korea University Medical Center, Department of Internal Medicine, Seoul, Korea Republic of
| | - Y Koretsune
- Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - B.-C Lee
- Hallym University Sacred Heart Hospital, Anyang-Si, Gyeonggi-Do, Korea Republic of
| | - P Levy
- Université Paris-Dauphine, PSL Research University, LEDa [LEGOS], Paris, France
| | | | - C.-C Wang
- Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ROC
| | - P Kirchhof
- University of Birmingham, School of Clinical and Experimental Medicine, Birmingham, United Kingdom
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Koretsune Y, Yamashita T, Kim YH, Wang CC, Bruggenjurgen B, Levy P, Lee BC, De Caterina R, Kirchhof P. P1004The global ETNA-AF registry programme: snapshot baseline demographics and patient characteristics from more than 17,700 atrial fibrillation patients on edoxaban. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Koretsune
- Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | - Y.-H Kim
- Korea University College of Medicine and Korea University Medical Center, Department of Internal Medicine, Seoul, Korea Republic of
| | - C.-C Wang
- Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ROC
| | - B Bruggenjurgen
- Institute for Health Economics, Steinbeis-University, Berlin, Germany
| | - P Levy
- Université Paris-Dauphine, PSL Research University, LEDa [LEGOS], Paris, France
| | - B.-C Lee
- Hallym University Sacred Heart Hospital, Anyang-Si, Gyeonggi-Do, Korea Republic of
| | - R De Caterina
- Università degli Studi “G. D'Annunzio”, Institute of Cardiology, Chieti, Italy
| | - P Kirchhof
- University of Birmingham, School of Clinical and Experimental Medicine, Birmingham, United Kingdom
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Ling LH, Hunter RJ, Bruggenjurgen B, Darius H, De Caterina R, Iqbal K, Le Heuzey JY, Kirchoff P, Schmitt J, Zamorano JL, Schilling RJ. 44 * Sociodemographic and cardiovascular status but not anticoagulant choice independently predicts quality of life in patients with atrial fibrillation: results from the prefer in AF registry. Europace 2014. [DOI: 10.1093/europace/euu240.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Reinhold T, Willich SN, Bruggenjurgen B. Response to a Letter from Dr Falk Hoffman. Europace 2011. [DOI: 10.1093/europace/eur247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rossnagel K, Nolte CH, Muller-Nordhorn J, Jungehulsing GJ, Selim D, Bruggenjurgen B, Villringer A, Willich SN. Medical resource use and costs of health care after acute stroke in Germany. Eur J Neurol 2006; 12:862-8. [PMID: 16241975 DOI: 10.1111/j.1468-1331.2005.01091.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to determine the 12 months medical resource use following admission to hospital with acute stroke and to calculate costs from a societal perspective. Data of consecutive patients with confirmed stroke were analysed. Acute hospital data were taken from medical records, socio-demographic variables from patients' interviews. A follow-up questionnaire about resource utilization was completed by patients or proxies 12 months after acute hospital admission. Costs were calculated by multiplying medical resource units used with cost factors per unit. Mean age of a total of 383 patients was 65 years and 41% were female. The median length of the initial stay in the acute hospital was 12 days at an average cost of 4650 per patient (49% of direct costs). Rehabilitation (16%), readmission (11%), medication (9%), and nursing costs (6%) were other contributors to the direct costs which amounted to a total of 9452 +/- 7599 per patient during 12 months. Indirect cost amounted to a total of 2014 +/- 5312. Patients' age, severity and type of stroke influenced the total stroke-associated costs. The large economic burden of stroke indicates the need for assessing and improving efficient health care for affected patients.
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Affiliation(s)
- K Rossnagel
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
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Buhl R, Kardos P, Baare A, Richter K, Meyer-Sabellek W, Bruggenjurgen B, Willich S, Vogelmeier C. Symptom-guided adjustable dosing asthma therapy with budesonide and formoterol in a single inhaler—The ATACO study. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80390-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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