Stroke Clinical Trial
Official title:
Prospective Monitoring of Non-Vitamin K Oral Anticoagulants in Older Adults With Atrial Fibrillation and Frailty
Verified date | May 2021 |
Source | Brigham and Women's Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The objective of this study is to establish a near-real-time prospective monitoring program in Medicare, Optum and MarketScan Research data to evaluate the benefit of new cardiovascular disease (CVD) drugs for older adults with frailty. Prospective monitoring program seeks to find early effectiveness and safety signals of new drugs by updating the analysis at regular intervals as new Medicare data become available. This study specifically aims to emulate a prospective surveillance of the effectiveness and safety of non-vitamin K oral anticoagulants (NOAC) vs. a comparator, warfarin, in older adults with atrial fibrillation and different frailty status. This program will be enhanced by incorporating a novel claims-based frailty index, which has been shown useful in assessing how the benefits and harms of drug therapy vary by frailty.
Status | Active, not recruiting |
Enrollment | 1000000 |
Est. completion date | December 31, 2022 |
Est. primary completion date | December 31, 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility | Inclusion Criteria: - Initiation of a NOAC or warfarin (day 0 is the initiation day) - Continuous enrollment in medical and drug insurance in [-183, 0] days - Diagnosis of AF in [-183, 0] days - CHA2DS2-VASc score =2 (moderate or high risk for stroke) - No prior use of NOAC or warfarin in [-183, -1] days - No recent hospitalization for stroke or major bleeding in [-60, 0] days - No recent nursing facility stay in [-60, 0] days Exclusion Criteria: - Contraindication to either drug in [-183, 0] days - Valvular heart disease or mechanical heart valve in [-183, 0] days - Intracranial or retroperitoneal hemorrhage in [-183, 0] days - Chronic kidney disease stage V, end-stage renal disease, or dialysis in [-183, 0] days - Other indications for anticoagulation therapy in [-183, 0] days |
Country | Name | City | State |
---|---|---|---|
United States | Brigham and Women's Hospital | Boston | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Brigham and Women's Hospital |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of patients with composite events of stroke or systemic embolism | Stroke OR systemic embolism, identified by relevant diagnoses in the claims data | January 2013 - December 2020 (after drug initiation) | |
Primary | Number of patients with major bleeding | Major bleeding, identified by relevant diagnoses in the claims data | January 2013 - December 2020 (after drug initiation) | |
Secondary | Number of patients with all-cause mortality | All-cause mortality is defined by the National Death Index file or vital status information in the claims data. | January 2013 - December 2020 (after drug initiation) |
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