Surprise findings on NOAC adherence

One in three patients prescribed a NOAC become non-adherent within six months and are at greater risk of stroke, Canadian researchers have found.

Their research shows much higher non-adherence in the real world than in the original NOAC trials, which may “limit the expected benefits” of the drugs over warfarin.

The retrospective study looked at the use of two NOACs, dabigatran and rivaroxaban, in 26,000 patients from 1998 to 2014.

Within six months of starting medication, 36% of dabigatran users and 32% of dabigatran users had had periods of two weeks or more of not taking their drugs.

Those patients had a four-fold and six-fold higher risk of stroke or TIA with dabigatran and rivaroxaban non-persistence, respectively. They also had an 80% greater combined risk of TIA, stroke or death, compared with compliant counterparts.

The difference between real-world and clinical trial non