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Trends in prescribing and outcomes in obese versus non-obese patients receiving rivaroxaban therapy: an observational study using real-world data

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submitted on 2024-01-10, 08:07 and posted on 2024-01-15, 04:50 authored by Majdoleen Alalawneh, Ousama Rachid, Ibtihal Abdallah, Ahmed Mahfouz, Hazem Elewa, Mohammed Ibn-Mas‘ud Danjuma, Asmaa Ezzeldin Mohamed, Ahmed Awaisu

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 Nature

Publication 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

Methodology

This was a retrospective cohort study involving all patients who received rivaroxaban therapy across all Hamad Medical Corporation (HMC) hospitals from 2015 to 2020.