Trial Outcomes & Findings for The Safety and Effectiveness of Warfarin and Dabigatran Prescribed in the Non-Valvular Atrial Fibrillation Population With DoD Healthcare Coverage (NCT NCT02043808)

NCT ID: NCT02043808

Last Updated: 2015-07-03

Results Overview

Event rate of stroke (hemorrhagic, ischemic). Variables in the final propensity score model: age, gender index year, baseline CHADS(2) score (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior Stroke or transient ischemic attack (TIA) or Thromboembolism), baseline CHA(2)DS(2)-VASc score (Congestive heart failure, Hypertension, Age ≥75 years (doubled), Diabetes mellitus, Stroke (doubled), Vascular disease, Age 65-74 years, Sex category), baseline HAS-BLED score (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile International Normalized Ratio, Elderly, Drugs/alcohol concomitantly), baseline use of several medications and presence of several baseline co-morbidities. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Recruitment status

COMPLETED

Target enrollment

25586 participants

Primary outcome timeframe

From October 1, 2009 through July 31, 2013 (the study period)

Results posted on

2015-07-03

Participant Flow

Existing data cohort design with propensity score matching (PSM). Variables included in the final propensity score model were: age, gender index year, baseline CHADS(2) score, baseline CHA(2)DS(2)-VASc score, baseline HAS-BLED score, baseline use of several medications and presence of several baseline co-morbidities.

Participant milestones

Participant milestones
Measure
Dabigatran
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Overall Study
STARTED
12793
12793
Overall Study
COMPLETED
12793
12793
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The Safety and Effectiveness of Warfarin and Dabigatran Prescribed in the Non-Valvular Atrial Fibrillation Population With DoD Healthcare Coverage

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Total
n=25586 Participants
Total of all reporting groups
Age, Continuous
73.8 years
STANDARD_DEVIATION 9.3 • n=5 Participants
74.0 years
STANDARD_DEVIATION 9.0 • n=7 Participants
73.9 years
STANDARD_DEVIATION 9.2 • n=5 Participants
Sex: Female, Male
Female
5277 Participants
n=5 Participants
5253 Participants
n=7 Participants
10530 Participants
n=5 Participants
Sex: Female, Male
Male
7516 Participants
n=5 Participants
7540 Participants
n=7 Participants
15056 Participants
n=5 Participants

PRIMARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period)

Population: All patients in the post-propensity score matching cohort

Event rate of stroke (hemorrhagic, ischemic). Variables in the final propensity score model: age, gender index year, baseline CHADS(2) score (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior Stroke or transient ischemic attack (TIA) or Thromboembolism), baseline CHA(2)DS(2)-VASc score (Congestive heart failure, Hypertension, Age ≥75 years (doubled), Diabetes mellitus, Stroke (doubled), Vascular disease, Age 65-74 years, Sex category), baseline HAS-BLED score (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile International Normalized Ratio, Elderly, Drugs/alcohol concomitantly), baseline use of several medications and presence of several baseline co-morbidities. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Stroke (Hemorrhagic, Ischemic)
9.15 Events per 1000 person-years
Interval 7.41 to 11.19
13.19 Events per 1000 person-years
Interval 10.74 to 16.05

PRIMARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period)

Population: All patients in the post-propensity score matching cohort

Event rate of major bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Bleeding
30.84 Events per 1000 person-years
Interval 27.55 to 34.42
37.04 Events per 1000 person-years
Interval 32.82 to 41.65

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period)

Population: All patients in the post-propensity score matching cohort

Event rate of ischemic stroke. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Ischemic Stroke
8.48 Events per 1000 person-years
Interval 6.8 to 10.45
10.69 Events per 1000 person-years
Interval 8.49 to 13.28

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of hemorrhagic stroke. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Hemorrhagic Stroke
0.77 Events per 1000 person-years
Interval 0.33 to 1.51
2.50 Events per 1000 person-years
Interval 1.5 to 3.9

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major intracranial bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Intracranial Bleeding
2.69 Events per 1000 person-years
Interval 1.79 to 3.88
5.65 Events per 1000 person-years
Interval 4.09 to 7.62

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major extracranial bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Extracranial Bleeding
28.13 Events per 1000 person-years
Interval 24.99 to 31.55
31.30 Events per 1000 person-years
Interval 27.44 to 35.56

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major gastrointestinal (GI) bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major GI Bleeding
25.40 Events per 1000 person-years
Interval 22.42 to 28.66
23.69 Events per 1000 person-years
Interval 20.34 to 27.42

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major upper gastrointestinal (GI) bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Upper GI Bleeding
5.48 Events per 1000 person-years
Interval 4.15 to 7.1
7.63 Events per 1000 person-years
Interval 5.8 to 9.87

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major lower gastrointestinal (GI) bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Lower GI Bleeding
20.25 Events per 1000 person-years
Interval 17.6 to 23.18
16.38 Events per 1000 person-years
Interval 13.62 to 19.52

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major urogenital bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Urogenital Bleeding
1.06 Events per 1000 person-years
Interval 0.53 to 1.89
3.02 Events per 1000 person-years
Interval 1.92 to 4.54

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of major other bleeding. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Major Other Bleeding
1.92 Events per 1000 person-years
Interval 1.17 to 2.97
5.13 Events per 1000 person-years
Interval 3.65 to 7.01

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of transient ischemic attacks. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Transient Ischemic Attack
4.62 Events per 1000 person-years
Interval 3.4 to 6.12
5.53 Events per 1000 person-years
Interval 3.99 to 7.48

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of myocardial infarction. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Myocardial Infarction
5.09 Events per 1000 person-years
Interval 3.82 to 6.66
7.77 Events per 1000 person-years
Interval 5.92 to 10.03

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of venous thromboembolism. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Venous Thromboembolism
1.34 Events per 1000 person-years
Interval 0.73 to 2.25
2.10 Events per 1000 person-years
Interval 1.2 to 3.42

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of deep vein thrombosis. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Deep Vein Thrombosis
0.58 Events per 1000 person-years
Interval 0.21 to 1.25
1.31 Events per 1000 person-years
Interval 0.63 to 2.42

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of pulmonary embolism. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Pulmonary Embolism
0.77 Events per 1000 person-years
Interval 0.33 to 1.51
0.79 Events per 1000 person-years
Interval 0.29 to 1.72

SECONDARY outcome

Timeframe: From October 1, 2009 through July 31, 2013 (the study period).

Population: All patients in the post-propensity score matching cohort

Event rate of death, due to any cause. The 12-month period prior to and including the index date was defined as the baseline period. Patients were required to have an NVAF diagnosis during this baseline period.

Outcome measures

Outcome measures
Measure
Dabigatran
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for dabigatran (either FDA-approved dose) during the study identification period (1 October 2010 and 31 July 2012).
Warfarin
n=12793 Participants
Oral anticoagulant treatment-naive non-valvular atrial fibrillation (NVAF) patients aged 18-89 with their first prescription claim for warfarin during the study identification period (1 October 2010 and 31 July 2012).
Death
31.28 Events per 1000 person-years
Interval 27.98 to 34.87
52.41 Events per 1000 person-years
Interval 47.4 to 57.82

Adverse Events

Dabigatran

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Warfarin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Boehringer Ingelheim Call Center

Boehringer Ingelheim

Phone: 1-800-243-0127

Results disclosure agreements

  • Principal investigator is a sponsor employee Boehringer Ingelheim (BI) acknowledges that investigators have the right to publish the study results. Investigators shall provide BI with a copy of any publication or presentation for review prior to any submission. Such review will be done with regard to proprietary information, information related to patentable inventions, medical, scientific, and statistical accuracy within 60 days. BI may request a delay of the publication in order to protect BI's intellectual property rights.
  • Publication restrictions are in place

Restriction type: OTHER