Rivaroxaban may be an effective treatment option over warfarin for patients with atrial fibrillation (AF), regardless of diabetes status, research from the ROCKET-AF trial has revealed.
The study analysed more than 5,000 patient records of people with diabetes mellitus. Analysing those treated with warfarin and rivaroxaban, it found no significant differences in stroke and systemic embolism rates, or in major bleeding and intracerebral haemorrhage. Similarly, there were no differences between patients who had diabetes and those that didn’t.
The findings were published online in the American Heart Journal.
Previous findings, reported by heartwire from Medscape, from ROCKET-AF showed that rivaroxaban once daily was not inferior to adjusted-dose warfarin in patients with nonvalvular AF and caused fewer incidents of intracranial and fatal bleeding. However, this is the first time that data specific to patients with both AF and diabetes has been released.
The current analysis found that overall adjusted rates of stroke, systemic embolism and bleeding were higher in those with diabetes against those without. However, diabetic status did not have a meaningful impact on treatment effectiveness.
For participants with diabetes, the rate of stroke or systemic embolism was 1.74 per 100 patient-years for the group that received rivaroxaban vs 2.14 per 100 patient-years for those receiving warfarin (HR 0.82). The rate was 2.12 vs 2.32/100 patient years, respectively, for the patients who did not have diabetes (HR 0.92).
The rates of ischemic stroke or systemic embolism was 1.48 vs 1.55/100 patient-years for the two treatment groups who had diabetes (HR 0.97), and 1.71 vs 1.80/100 patient years for those without (HR 0.95).
There were also no significant differences between the two treatment groups in regard to the safety end points.
The news follows NICE approval for edoxaban, which was found to nearly half the rate of haemorrhage stroke events compared to warfarin. You can read more about the approval here [https://bjfm.co.uk/nice-approves-new-stroke-prevention-treatment.aspx]