PMID- 30443944
OWN - NLM
STAT- MEDLINE
DCOM- 20190923
LR  - 20190923
IS  - 1099-1557 (Electronic)
IS  - 1053-8569 (Linking)
VI  - 27
IP  - 12
DP  - 2018 Dec
TI  - Direct oral anticoagulant use and subsequent start of proton pump inhibitors as 
      proxy for gastric complaints.
PG  - 1371-1378
LID - 10.1002/pds.4684 [doi]
AB  - PURPOSE: Dabigatran use has been linked to gastrointestinal complaints, but it is 
      unknown if this leads to more use of proton pump inhibitors (PPI). Furthermore, 
      it is unknown whether gastrointestinal complaints occur more frequently in 
      dabigatran users compared with other direct oral anticoagulant (DOACs) users. We 
      investigated the association between DOAC use (dabigatran, rivaroxaban, or 
      apixaban) and subsequent PPI initiation as a proxy for gastrointestinal 
      complaints. METHODS: In this population-based observational study with an 
      active-comparator new user study design, anonymised dispensing data from 
      Community Pharmacies in the Netherlands from 2012 to 2016 were used. Patients 
      initiating DOAC for the treatment of atrial fibrillation without any PPI use 
      before or at time of DOAC initiation were included. The outcome measure, 
      subsequent PPI initiation, was determined in 28553 DOAC users. RESULTS: The 
      patients initiating dabigatran (10 942), apixaban (4897), or rivaroxaban (12714) 
      were comparable for age (mean 69 years), sex (62% men), socioeconomic class, and 
      concomitant medication use. The risk of PPI initiation in apixaban versus 
      rivaroxaban users was similar (adjusted hazard ratio 1.06; 95% confidence 
      interval 0.96-1.31) The adjusted hazard ratio of initiating PPI for dabigatran 
      users was 1.21 (95% confidence interval 1.14-1.29) compared with 
      rivaroxaban/apixaban users. The cumulative incidence of PPI initiation at 
      6 months of follow-up for patients using dabigatran was 13.0%, and 10.0% for 
      those using rivaroxaban/apixaban, yielding a number needing treatment of 33. 
      CONCLUSIONS: Proton pump inhibitor initiation occurred frequently in incident 
      DOAC users but more often in patients treated with dabigatran than in those 
      treated with rivaroxaban or apixaban.
CI  - (c) 2018 John Wiley & Sons, Ltd.
FAU - Zielinski, G Denise
AU  - Zielinski GD
AUID- ORCID: 0000-0003-1046-4055
AD  - Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 
      The Netherlands.
FAU - Teichert, Martina
AU  - Teichert M
AD  - Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, 
      Leiden, The Netherlands.
FAU - Klok, Frederikus A
AU  - Klok FA
AD  - Department of Thrombosis and Haemostasis, Leiden University Medical Center, 
      Leiden, The Netherlands.
FAU - Rosendaal, Frits R
AU  - Rosendaal FR
AD  - Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 
      The Netherlands.
FAU - Huisman, Menno V
AU  - Huisman MV
AD  - Department of Thrombosis and Haemostasis, Leiden University Medical Center, 
      Leiden, The Netherlands.
FAU - Cannegieter, Suzanne C
AU  - Cannegieter SC
AD  - Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 
      The Netherlands.
AD  - Department of Thrombosis and Haemostasis, Leiden University Medical Center, 
      Leiden, The Netherlands.
FAU - Lijfering, Willem M
AU  - Lijfering WM
AD  - Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 
      The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20181115
PL  - England
TA  - Pharmacoepidemiol Drug Saf
JT  - Pharmacoepidemiology and drug safety
JID - 9208369
RN  - 0 (Anticoagulants)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Pyrazoles)
RN  - 0 (Pyridones)
RN  - 3Z9Y7UWC1J (apixaban)
RN  - 9NDF7JZ4M3 (Rivaroxaban)
RN  - I0VM4M70GC (Dabigatran)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Anticoagulants/administration & dosage/*adverse effects
MH  - Atrial Fibrillation/complications/*drug therapy
MH  - Dabigatran/administration & dosage/*adverse effects
MH  - Drug Prescriptions/statistics & numerical data
MH  - Female
MH  - Gastrointestinal Diseases/chemically induced/drug therapy/*epidemiology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Netherlands/epidemiology
MH  - Proportional Hazards Models
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Pyrazoles/administration & dosage/adverse effects
MH  - Pyridones/administration & dosage/adverse effects
MH  - Risk Factors
MH  - Rivaroxaban/administration & dosage/adverse effects
MH  - Stroke/epidemiology/etiology/prevention & control
OTO - NOTNLM
OT  - anticoagulants
OT  - atrial fibrillation
OT  - gastrointestinal
OT  - pharmacoepidemiology
OT  - proton pump inhibitors
OT  - risk
EDAT- 2018/11/18 06:00
MHDA- 2019/09/24 06:00
CRDT- 2018/11/17 06:00
PHST- 2018/03/29 00:00 [received]
PHST- 2018/09/25 00:00 [revised]
PHST- 2018/09/27 00:00 [accepted]
PHST- 2018/11/18 06:00 [pubmed]
PHST- 2019/09/24 06:00 [medline]
PHST- 2018/11/17 06:00 [entrez]
AID - 10.1002/pds.4684 [doi]
PST - ppublish
SO  - Pharmacoepidemiol Drug Saf. 2018 Dec;27(12):1371-1378. doi: 10.1002/pds.4684. 
      Epub 2018 Nov 15.