Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS‐ACTS Substudy Academic Article uri icon

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  • ABSTRACTBackgroundThe efficacy, safety, and ease of use of rivaroxaban may reduce anticoagulation‐treatment burden and improve nonvalvular atrial fibrillation (NVAF) patient satisfaction compared with vitamin K antagonists (VKAs).HypothesisTransitioning from a VKA to rivaroxaban improves treatment satisfaction in routine practice.MethodsXarelto for Prevention of Stroke in Patients With Atrial Fibrillation (XANTUS) is a prospective, noninterventional study in patients with NVAF prescribed rivaroxaban for prevention of stroke in routine practice. Patients receiving a VKA 4 weeks prior to the initial XANTUS study visit and switched to rivaroxaban were asked to complete the Anti‐Clot Treatment Scale (ACTS). Changes from the initial visit to the first follow‐up visit at ∼ 3 months (corresponding to a comparison of rivaroxaban vs prior VKA) for ACTS burden and benefit scores were calculated using and reported as least squared mean differences (LSMDs) with 95% confidence intervals (CIs).ResultsThe study included 1291 NVAF patients with prior VKA treatment. The mean baseline ACTS burden and benefit scores were 50.51 ± 8.42 and 10.30 ± 2.70, respectively. After ∼ 3 months of rivaroxaban treatment, LSMDs were 4.38 points (95% CI: 2.53‐6.22, P < 0.0001) for the burden and 1.01 points (95% CI: 0.27‐1.75, P = 0.0075) for the benefit score. Fifty‐four percent and 48% of patients reported experiencing at least a minimally important clinical difference in burden and benefit scores, respectively.ConclusionsWithin this XANTUS cohort, switching from a VKA to rivaroxaban yielded statistically and clinically significant improvements in ACT burden and benefit scores.


  • Coleman, Craig I
  • Haas, Sylvia
  • Turpie, Alexander Graham Gri
  • Kuhls, Silvia
  • Hess, Susanne
  • Evers, Thomas
  • Amarenco, Pierre
  • Kirchhof, Paulus
  • Camm, A John

publication date

  • October 2016

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