Supplementary data: Evaluation of the treatment patterns among commercially insured patients with nonvalvular atrial fibrillation prescribed an oral anticoagulant by race/ethnicity

<p dir="ltr"><b>These are peer-reviewed supplementary materials for the article</b><b> </b><b>'</b><b>Evaluation of the treatment patterns </b><b>among commercially insured patients with </b><b>nonvalvular atrial fibrillation prescribed an </b><b>oral anticoagulant by race/ethnicity</b><b>'</b><b> </b><b>published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b></p><ul><li><b>Table S1: </b>Pre-IPTW demographic and baseline clinical characteristics in apixaban-warfarin cohort</li><li><b>Table S2: </b>Pre-IPTW demographic and baseline clinical characteristics in DOAC-warfarin cohort</li><li><b>Table S3: </b>Pre-IPTW demographic and baseline clinical characteristics among Asian/Pacific Islander and Other/Unknown race/ethnicity subgroups in apixaban-warfarin cohort</li><li><b>Table S4: </b>Pre-IPTW demographic and baseline clinical characteristics among Asian/Pacific Islander and Other/Unknown race/ethnicity subgroups in DOAC-warfarin cohort</li><li><b>Table S5: </b>Proportion of discontinuers and TTD in apixaban-warfarin and DOAC-warfarin cohorts (sensitivity analysis)</li></ul><p dir="ltr"><br></p><p dir="ltr"><b>Aim:</b> Despite evidence of racial/ethnicity health inequities in oral anticoagulant initiation and clinical</p><p dir="ltr">outcomes for nonvalvular atrial fibrillation, little is known about disparities in treatment patterns,</p><p dir="ltr">particularly discontinuation and switching. <b>Materials & methods: </b>This retrospective study utilized</p><p dir="ltr">Komodo Healthcare Map data (1 July 2018 to 30 June 2023) to examine treatment patterns in patients</p><p dir="ltr">with nonvalvular atrial fibrillation initiating direct oral anticoagulants (DOACs: apixaban, rivaroxaban,</p><p dir="ltr">dabigatran) versus warfarin, stratified by self-reported race/ethnicity (White, Black and Hispanic) in the</p><p dir="ltr">USA. Inverse probability of treatment weighting balanced baseline covariates and Cox model computed</p><p dir="ltr">adjusted hazard ratio (aHR) and 95% confidence interval (CI) for apixaban-warfarin and DOAC-warfarin</p><p dir="ltr">comparisons in the overall cohort and by race/ethnicity. <b>Results:</b> In the apixaban-warfarin cohort,</p><p dir="ltr">apixaban patients were 24% less likely to discontinue treatment (aHR: 0.76, 95% CI: 0.75–0.77) and 79%</p><p dir="ltr">less likely to switch to another oral anticoagulant (aHR: 0.21, 95% CI: 0.20–0.22) versus warfarin. By</p><p dir="ltr">race/ethnicity, a higher proportion of Black patients discontinued than White and Hispanic (68, 60 and</p><p dir="ltr">63%, respectively). Almost 5%of apixaban patients switched to another oral anticoagulant versus 31% on</p><p dir="ltr">warfarin. Among warfarin switchers, 77% initiated apixaban (80% in White; 76% Black; 76% in Hispanic</p><p dir="ltr">patients). The DOAC-warfarin cohort followed similar trends. <b>Conclusion:</b> Overall, apixaban/DOACs were</p><p dir="ltr">associated with more favorable treatment patterns than warfarin. However, racial/ethnicity differences</p><p dir="ltr">were observed. Given the potential impact of oral anticoagulant discontinuation on clinical outcomes,</p><p dir="ltr">further research is needed to better understand factors contributing to higher discontinuation and switch</p><p dir="ltr">rates, particularly among Black and Hispanic patients.</p>