Trends in prescribing and outcomes in obese versus non-obese patients receiving rivaroxaban therapy: an observational study using real-world data
Purpose
To investigate real-world prescribing trends and clinical outcomes based on body mass index (BMI) categorization in patients who received rivaroxaban therapy.
Methods
This was a retrospective cohort study involving all patients who received rivaroxaban therapy across all Hamad Medical Corporation (HMC) hospitals from 2015 to 2020.
Results
The number of patients initiated on rivaroxaban therapy significantly increased from 152 (3.3%) in 2015 to 1342 (28.9%) in 2020 (p <0.001). Within BMI categories, a similar increasing trend was observed in underweight, normal, and overweight patients, while from 2018 to 2020, there was a decreasing trend in rivaroxaban prescribing in all obese classes. The prevalence rate of all-cause mortality differed significantly between the BMI groups, with the highest mortality being among morbidly obese patients (BMI ≥ 40 kg/m2) (p< 0.001). On the other hand, no significant differences were found between the BMI groups in terms of bleeding, pulmonary embolism, deep vein thrombosis and stroke incidences. Multivariate logistic regression analyses showed that the likelihood of all-cause mortality was significantly higher in overweight and all categories of obese patients compared to underweight patients: overweight (OR: 5.3, 95% CI: 2.3–11.9, p< 0.001); obese class 1 (OR: 5.4, 95% CI: 2.3 – 12.2, p< 0.001); obese class 2 (OR: 6.5, 95% CI: 2.7 – 15.6, p< 0.001); and obese class 3 (OR: 3.7, 95% CI: 1.6 – 8.7, p = 0.003).
Conclusions
Rivaroxaban prescribing has significantly increased over the years across general population, with a noticeable decline in obese population during the last few years (from 2018 onwards). Furthermore, an appreciable association was evident between all-cause mortality and BMI of these patients.
Other Information
Published in: European Journal of Clinical Pharmacology
License: https://creativecommons.org/licenses/by/4.0
See article on publisher's website: https://dx.doi.org/10.1007/s00228-023-03572-7
Additional institutions affiliated with: Clinical Pharmacy Services - Hamad General Hospital
Funding
Open Access funding provided by the Qatar National Library.
History
Language
- English
Publisher
Springer NaturePublication Year
- 2023
License statement
This Item is licensed under the Creative Commons Attribution 4.0 International License.Institution affiliated with
- Qatar University
- Qatar University Health - QU
- College of Pharmacy - QU HEALTH
- College of Medicine - QU HEALTH
- Hamad Medical Corporation
- Hamad General Hospital - HMC
- Heart Hospital - HMC