See what you know about the magnitude of the shift toward novel oral anticoagulants for atrial fibrillation.
The 4 so-called novel oral anticoagulants (NOACs) now are collectively the most widely used option for oral anticoagulation given to patients newly diagnosed with atrial fibrillation (AF). Their use now matches that of vitamin-K antagonist warfarin. In addtion, the NOACS--apixaban, rivaroxaban, dabigatran, and edoxaban--together have been linked to an uptick in use of oral ancticoagulation for patients with AF.
These 5 quick questions test how closely you’ve paid attention to the steady shift away from warfarin.
1. The first NOAC approved in the United States in late 2010 was:
Answer: C. Dabigatran
2. In Denmark, between 2011-2015, NOACs largely replaced warfarin and fueled a rise in the percentage of atrial fibrillation patients treated with an oral anticoagulant by:
Answer: A. 75%
3. Among 4800 US office-based physicians who had office visits with patients for AF between 2011 and 2014, the NOAC share of OAC use jumped from:
A. 5% of patients to 40%
B. 5% of patients to 45%
C. 6% of patients to 48%
D. 6% of patients to 36%
Answer C. 6% of patients to 48%
4. True or False? In 2014, dabigatran was the most commonly prescribed NOAC for atrial fibrillation (47.9% of office visits), followed by apixaban (26.5%) and rivaroxaban (25.5%).
Answer: B. False
In 2014, rivaroxaban was the most commonly prescribed NOAC for atrial fibrillation (47.9% of office visits), followed by apixaban (26.5%) and dabigatran (25.5%).
5. For extra credit: NOAC use documented during office visits for venous thromboembolism patients in the US is almost exclusively:
Answer: B. Rivaroaxaban
Zoler ML. NOACs outpace warfarin for afib anticoagulation [commentary]. Cardiology News. September 21, 2016.
Boehringer Ingelheim’s Pradaxa Available in U.S. Pharmacies Starting Wednesday, November 3 [press release]. Ridgefield, Conn: Boehringer Ingelheim Pharmaceuticals, Inc.; November 1, 2010.
Geoffrey D. Barnes GD, Lucas E, Alexander GC, Goldberger ZD. National trends in abulatory anticoagulant use. Am J Med. 2015;128:1300–1305.e2