Oral anticoagulants (OAC: vitamin K antagonists [VKAs], dabigatran, rivaroxaban, and apixaban) are used for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). While results from pivotal randomized trials are available, French-specific, “real-life” data pertaining to the four OAC treatments available are awaited.

This analysis of the NAXOS study aimed to describe demographic and clinical characteristics of NVAF patients initiating an OAC.

All patients aged≥18 years with NVAF and newly initiating one of the study OACs (i.e. no dispensation of the same OAC in the 24 prior months) between 2014 and 2016 were identified in the French national health insurance database (SNIIRAM–a comprehensive in- and outpatient healthcare consumption database). Patients were allocated to 4 different treatment cohorts. To maximise the comparability of populations, only OAC-naive patients (i.e. no dispensation of any OAC during the 24 months prior) were studied.

Overall, 321,501 AC-naive NVAF patients aged 18+ were identified. Of these, 112,628 (35.0%) initiated VKAs, while 87,565 (27.2%), 100,063 (31.1%), and 21,245 (6.6%) initiated apixaban, rivaroxaban and dabigatran, respectively. Median follow-up durations were 218, 213, 205 and 186 days for VKA, apixaban, rivaroxaban and dabigatran cohorts, respectively. Males represented 48.8% of patients in VKA cohort (mean age: 78.5), 51.2% in apixaban cohort (mean age: 74.7), 55.1% in rivarobaxan cohort (mean age: 72) and 54.1% in dabigatran cohort (mean age: 72.7). Median age-adjusted Charlson score was 6 in the VKA cohort, and 4 in the other three cohorts.

The NAXOS study confirms the widespread use of OAC treatments in France, suggesting differences between cohorts for age, gender and comorbidities. Thanks to large cohort sizes and prolonged follow-up, longitudinal analyses will allow assessment of real-life effects of OAC therapy in NVAF.