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CC BY-NC-ND 4.0 · Thromb Haemost 2024; 124(02): 152-162
DOI: 10.1055/a-2107-0815
Stroke, Systemic or Venous Thromboembolism

Dynamic Patterns and Persistence of Anticoagulation Therapy in Patients with Venous Thromboembolism in South Korea: A Nationwide Cohort Study

Dongwon Yoon
1   School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
2   Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
,
Han Eol Jeong
1   School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
2   Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
,
Songhwa Choi
3   Medical Affairs, Pfizer Korea Ltd., Seoul, South Korea
,
Ju-Young Shin
1   School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
2   Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
4   Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
,
Soo-Mee Bang
5   Division of Hemato-Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Comment on:

Patterns and Persistence of Anticoagulant Use in the Treatment of Venous Thromboembolism: Insights from South KoreaThromb Haemost 2024; 124(02): 163-165
DOI: 10.1055/a-2131-7066

Abstract

Background Venous thromboembolism (VTE) is associated with increased morbidity, mortality, and health care expenditure. However, the comprehensive utilization of anticoagulation therapy in patients with VTE, especially regarding active cancer, in real-world practice remains unclear.

Objective To describe the prescription, persistence, and patterns of anticoagulation therapy among patients with VTE stratified according to active cancer.

Methods Using Korean nationwide claims data, we identified an incident, treatment-naïve cohort of patients with VTE from 2013 to 2019 and classified them according to the presence/absence of active cancer. We explored the secular trends, treatment patterns (e.g., discontinuation, interruption, and switch), and persistence of anticoagulation therapy.

Results There were 48,504 and 7,255 patients without and with active cancer, respectively. Non-vitamin K antagonist oral anticoagulants (NOACs) were the most common anticoagulant in both groups (65.1 and 57.9%, respectively). The prescription of NOACs increased steeply over time, regardless of active cancer, whereas parenteral anticoagulants (PACs) plateaued and warfarin decreased sharply. A heterogeneous pattern was observed between the groups without and with active cancer (3-month persistence was 60.8, 62.9, 57.2, and 3.4%, respectively; 6-month persistence was 42.3, 33.5, 25.9, and 1.2% vs. 9.9%). Median durations of continuous anticoagulant therapy for warfarin, NOAC, and PAC were 183, 147, and 3 days in nonactive cancer patients, and 121, 117, and 44 days in active cancer patients.

Conclusion Our findings suggest that there were substantial differences in persistence, patterns, and patient characteristics of anticoagulant therapy based on index anticoagulant and active cancer.

Keywords

venous thromboembolism - anticoagulants - NOACs - treatment patterns - cancer

Supplementary Material



Publication History

Received: 20 December 2022

Accepted: 22 May 2023

Accepted Manuscript online:
07 June 2023

Article published online:
15 July 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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