Edoxaban for stroke prevention in atrial fibrillation and factors associated with dosing: patient characteristics from the prospective observational ETNA-AF-China registry
Authors: Guo Xueyuan , Du Juan , Yang Yang , Wu Mingxing , Ou Wenchao , Han Xuebin , Wang Zhifang , Jin Jing , Zhang Ping , Zhang Zheng , Chen Guoqin , Long Mingzhi , Yin Guotian , Liu Tong , Wang Xiaoyan , Li Dongsheng , Chen Manhua , Dong Yugang , Lai Chunlin , Zhang Xuelian , Yi Yuan , Xiang Jing , Chen Cathy , Unverdorben Martin , Ma Changsheng ,   ETNA-AF-China Investigators, Yin Yuehui , Qi Heng , Jia Zhisheng , Ji Xiaojun , Zhang Yuqing , Liang Xue , Deng Bing , Liu Jieyun , Ma Juan , Song Cangsang , Feng Huifang , Luo Suxin , Wang Jingfeng , Li Lun , Xiao Yongqi , Cui Junyou , Cheng Xiang , Huang Zheng , Wei Jiafu , Cheng Jinfang , Li Haiyan , Zhang Jun , Jiang Weihong , Liu Jie , Min Xinwen , Gao Peng , Gao Lianjun , Huang Zhouqing , Wang Ruxing , Li Ying , Ye Zebin , Wang Xubo , Lai Hengli , Wang Lihong , Zhang Minli , Wang Changqian , Mao Wei , Chen Xiaohua , Wang Zhirong , Liu Fang , Xie Xiaolin , Xu Zhenggui , Dong Bin , Zeng Hesong , Peng Jianqiang , Zhang Lihua , Zhao Qingyan , Liu Fucheng , Guo Caixia , Tang Lijiang , Li Xianjin , Zhou Jing , Yang Xinchun , Chen Xiaoshu , Liu Yajuan , Tong Tiebi , Tang Guanmin , Liu Jian , Lin Meise , Liu Bin , Fu Guosheng , Wang Weimin , Yang Qing , Tang Baopeng , Ran Boli , Xu Jianjiang , Yin Chunlin , Yang Pingzhen , Yang Fujie , Bai Ming , Zhang Jian 
Published: February 2024

Real-world data on effectiveness and safety of a single non-vitamin K antagonist oral anticoagulant in the Chinese population with atrial fibrillation (AF) are limited. This study reports characteristics of patients treated with edoxaban and factors associated with dosing patterns from routine care in China. ETNA-AF-China (NCT04747496) is a multicentre, prospective, observational study enrolling edoxaban-treated patients from four economic regions with a targeted 2-year follow-up. Of the 4930 patients with AF (mean age: 70.2 ± 9.5 years; male, 57.1%), the mean creatinine clearance (CrCl), CHA2DS2-VASc, and HAS-BLED scores were 71.2 mL/min, 2.9, and 1.6. Overall, 6.4% of patients were perceived as frail by investigators. Available label dose reduction criteria (N = 4232) revealed that 3278 (77.5%) patients received recommended doses and 954 (22.5%) non-recommended doses. Northeast (53.0%) and West (43.1%) regions had the highest prescriptions of 60 mg and 30 mg recommended doses, respectively. Non-recommended 30 mg doses were more frequently prescribed in patients with antiplatelet use and history of heart failure than recommended 60 mg. Multivariate analysis identified advanced age as the strongest associated factor with non-recommended doses. Frailty had the strongest association with 30 mg except for age, and history of TIA was the most relevant factor associated with 60 mg. In conclusion, patients in the ETNA-AF-China study were predominantly aged 65 years and older, had mild-to-moderate renal impairment and good label adherence. Advanced age was associated with non-recommended doses, with frailty most common for non-recommended 30 mg and a history of TIA for the non-recommended 60 mg dose.