Prescribing of low‐dose rivaroxaban in patients with atherosclerotic cardiovascular disease in the United Kingdom and the Netherlands

摘要

Aims Low‐dose rivaroxaban has been indicated for the management of atherosclerotic cardiovascular disease (ASCVD) after recent (2019‐2020) updates to European guidelines. We aimed to describe prescription trends of low‐dose rivaroxaban in ASCVD patients over the period 2015‐2022 in two European countries, to compare the trends before and after guideline changes, and to determine the characteristics of users. Methods In a cross‐sectional interrupted time series analysis, utilization of low‐dose rivaroxaban (2.5?mg, twice daily) was measured in Clinical Practice Research Datalink Aurum (United Kingdom UK) and the PHARMO Database Network (the Netherlands) from 1 January 2015 to 28 February 2022 in patients with an ASCVD diagnosis. Incidence rates (IRs) and incidence rate ratios (IRRs) of new use (within 182?days) compared to the reference period, 2015‐2018, were calculated. Age, sex and comorbidities of users were compared to those of nonusers. Results In the UK, from 721?271 eligible subjects the IR of new use of low‐dose rivaroxaban in the period 2015‐2018, before guideline changes, was 12.4 per 100?000 person‐years and after guideline changes in 2020‐2022 was 124.0 (IRR 10.0, 95 confidence interval CI 8.5, 11.8). In the Netherlands from 394?851 subjects, the IR in 2015‐2018 was 2.4 per 100?000 person‐years and in 2020 was 16.3 (IRR 6.7, 95 CI 4.0, 11.4). Users were younger (UK mean difference MD ?6.1?years, Netherlands ?2.4?years; P?