RESEARCH ARTICLE


Profiling Clinical Characteristics and Treatment Patterns Among Non-Valvular Atrial Fibrillation Patients: A Real-World Analysis in Dubai, United Arab Emirates



Moutaz El Kadri1, *, Nooshin Bazargani2, Mohamed Farghaly3, Rauf Mohamed4, Nancy Awad4, Ashok Natarajan4, Prathamesh Pathak4, Ahmed Ghorab5, Nader El Kakoun5, Mirko Savone5, Sid Ahmed Kherraf5, Jack Mardekian6, Manuela Di Fusco6
1 Sheikh Khalifa Medical City, Abu Dhabi, UAE
2 Dubai Hospital, Dubai, UAE
3 Dubai Health Authority, Dubai, UAE
4 Real World Evidence, IQVIA, USA
5 Pfizer Gulf, Dubai, UAE
6 Pfizer, Inc., New York, NY, USA


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© 2019 El Kadri et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Shaikh Khalifa Medical City, P.O. Box 51900, Abu Dhabi, UAE; Tel: +9712819 4526; Fax: +97126103011;
E-mail: mkadri@seha.ae


Abstract

Background:

There is a dearth of real-world evidence regarding patient characteristics, Oral Anti-Coagulant (OAC) treatment, and International Normalized Ratio (INR) patterns in Dubai, United Arab Emirates (UAE).

Methods:

This was a retrospective observational study among newly diagnosed adult Non-valvular Atrial Fibrillation (NVAF) patients in the Dubai Real World Claims Database. Selected patients had at least one activity claim during the 12 months pre-index date (baseline period), and a pharmacy claim for apixaban, dabigatran, rivaroxaban, or warfarin from 01 JAN 2015-31 JUL 2017. Patients with valvular heart disease, cardiac surgery, venous thromboembolism, transient atrial fibrillation, pregnancy, or OAC claims during baseline were excluded. Comorbidities and treatment patterns related to OAC use, index dosing, baseline medications, and INR patterns were described.

Results:

Among 5,072 NVAF patients, 468 met the study criteria. A minority of them (14.3%) were prescribed warfarin, and the most frequently prescribed non-vitamin K antagonist OACs (NOACs) were rivaroxaban (33.3%) and apixaban (31.4%), followed by dabigatran (20.9%). Patients’ mean age was 59 years and mean CHA2DS2-VASc score was 2.3, with most frequent comorbidities of diabetes mellitus, hypertension, coronary artery disease, and peripheral vascular disease. Additionally, 51% and 33% were on statins and aspirin, respectively, while 39% were on other anticoagulant agents. A large proportion of dabigatran patients were on a lower dose (57%). INR patterns revealed 13% of rivaroxaban, 12% of apixaban, and 7% of dabigatran patients had INR claims.

Conclusion:

This study provides relevant insights into the use of OACs in real-world clinical practice settings in Dubai, UAE.

Keywords: Atrial fibrillation, Apixaban, Dabigatran, Rivaroxaban, Warfarin, Dubai, UAE.