Study to Evaluate the Use of Direct Oral Anticoagulants in UK Clinical Practice For Patients With a First Stroke Attributable to Nonvalvular Atrial Fibrillation

NCT ID: NCT05262322

Last Updated: 2022-07-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

234 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-02-15

Study Completion Date

2021-07-09

Brief Summary

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National Institute of Health and Care Excellence (NICE) guidance recommends anticoagulation for stroke prevention in high risk patients with nonvalvular atrial fibrillation (AF).

Early evidence suggest that patients with atrial fibrillation (AF) who do not receive anticoagulation are more likely to experience a stroke. However, the characteristics of patients experiencing a first AF-related stroke in real-world settings, who have not been receiving anticoagulation, have not been well documented.

It is unclear how the direct anti-FXa oral anticoagulants have been used within real world practice since the introduction of edoxaban in 2015.

Detailed Description

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This non-interventional study will focus specifically on the patient characteristics, management pathways, and patient reported experiences associated with real world use of three direct anti-FXa oral anticoagulants (DOAC) commonly used within United Kingdom clinical practice; apixaban, rivaroxaban and edoxaban.

The primary objective will describe the demographics, clinical characteristics and medical history of patients presenting with a first ischaemic stroke with AF who have not received anticoagulation (for any reason) in the 12 months prior to stroke, by type of anticoagulant treatment subsequently prescribed for secondary prophylaxis of stroke.

Secondary objectives of the study will describe management pathways of patients initiated on DOACs (apixaban, edoxaban or rivaroxaban) for secondary prophylaxis of stroke, including timing and reasons for any dose changes or treatment switches to alternative anticoagulants; describe hospital resource use and clinical assessments associated with DOAC treatment for secondary prophylaxis of stroke; describe real world patient-reported adherence to DOACs for secondary prophylaxis of stroke; and describe patient experience and treatment satisfaction for patients receiving DOAC therapy for secondary prophylaxis of stroke.

Conditions

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Atrial Fibrillation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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All Participants (Group 1; Retrospective)

All participants' data will be collected retrospectively from medical records 12 months prior to the date of diagnosis of a first ischaemic stroke attributable to nonvalvular AF

No interventions assigned to this group

Subset of All Participants (Group 2; Prospective)

A subset of participants from Group 1 who were initiated on apixaban, edoxaban or rivaroxaban for secondary prophylaxis of stroke will take part in this prospective component of the study, whereby data on their management pathway (treatments and follow-up appointments) and patient-reported outcomes will be collected for 6 months from the date of first dose of DOAC treatment.

Edoxaban

Intervention Type DRUG

This was a non-interventional, observational study. No drug was administered in this study.

Apixaban

Intervention Type DRUG

This was a non-interventional, observational study. No drug was administered in this study.

Rivaroxaban

Intervention Type DRUG

This was a non-interventional, observational study. No drug was administered in this study.

Interventions

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Edoxaban

This was a non-interventional, observational study. No drug was administered in this study.

Intervention Type DRUG

Apixaban

This was a non-interventional, observational study. No drug was administered in this study.

Intervention Type DRUG

Rivaroxaban

This was a non-interventional, observational study. No drug was administered in this study.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

\- For all patients:

* Participants presenting to the study centre with a first ischaemic stroke which is, in the clinician's opinion, attributable to nonvalvular AF
* Participants aged 18 years or over at time of first stroke

For group 2 patients:

\* Participants initiated on apixaban, edoxaban or rivaroxaban after their first stroke

Exclusion Criteria

* For all patients:

* Participants prescribed any anticoagulant for any purpose in the 12 months prior to stroke diagnosis
* Participants with haemorrhagic stroke
* Participants with diagnosis of transient ischemic attack
* Participants with severe cognitive or emotive deficit
* Participants whose medical records are not available for review
* Participant unwilling or unable to give written informed consent
* For group 2 patients:

* Participant unwilling or unable to complete the patient-reported questionnaires
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Daiichi Sankyo UK Ltd, a Daiichi Sankyo Company

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Global Clinical Leader

Role: STUDY_DIRECTOR

Daiichi Sankyo

Locations

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Queen Elizabeth University Hospital - NHS Greater Glasgow and Clyde

Glasgow, , United Kingdom

Site Status

Gloucestershire Royal Hospital - Gloucestershire Hospitals NHS Foundation Trust

Gloucester, , United Kingdom

Site Status

Leicester Royal Infirmary - University Hospitals of Leicester NHS Trust

Leicester, , United Kingdom

Site Status

St George's Hospital - St George's University Hospital's NHS Foundation Trust

London, , United Kingdom

Site Status

Royal Victoria Infirmary - Newcastle upon Tyne Hospitals NHS Foundation Trust

Newcastle, , United Kingdom

Site Status

Royal Gwent Hospital - Aneurin Beban University Health Board

Newport, , United Kingdom

Site Status

Musgrove park Hospital - Taunton and Somerset NHS Foundation Trust

Taunton, , United Kingdom

Site Status

Yeovil District Hospital - Yeovil District Hospital NHS Foundation Trust

Yeovil, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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EDX/18/0414(2)

Identifier Type: -

Identifier Source: org_study_id

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