3.8 Article

Atrial fibrillation therapy with new oral anticoagulants: a real world evidence study

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ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/20479700.2023.2273025

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Cardiology; atrial fibrillation; anticoagulants; pharmacoutilization; governance

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Atrial fibrillation, a common heart condition among the elderly, has seen a shift from traditional therapy to new oral anticoagulants (NOACs) in recent years, particularly after the Covid-19 pandemic. The consumption of NOACs has significantly increased since the introduction of new regulations, and there has been a notable rise in the number of patients with atrial fibrillation. These findings highlight the unmet therapeutic needs and the impact of Long Covid phenomena on the cardiovascular system.
Atrial fibrillation is a condition which frequently occurs in the elderly causing a contraction of a portion of the heart. It can be either perceived as an uncomfortable sensation or it may be completely silent, but when untreated, it can impact negatively on human health. In recent years, traditional therapy based on warfarin and acenocoumarol has been increasingly replaced by new oral anticoagulants (NOACs), especially after the Covid-19 pandemic and the introduction of note 97 by the Italian Medicines Agency (AIFA). By the extraction of all the prescriptions and dispensations between 2019 and 2022, it has been assessed the consumption and expenditure in relation to the treatment of atrial fibrillation. Compared to traditional therapy, the consumption of NOACs has significantly increased after the introduction of the new regulations. Moreover, compared to previous years, since 2021 the number of patients affected by atrial fibrillation has significantly increased. Although in several cases the prescription has been inappropriate, this data is traceable to an unmet therapeutic need and the effects of Long Covid phenomena which affect the cardiovascular system.

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