There was a lack of data on the use of oral anticoagulants (OAC) for stroke prevention in cancer patients with atrial fibrillation (AF). Nationwide cohort analysis of 12,756 individuals with AF and an indication for OAC (2012–2018) who were diagnosed with cancer at least one year later (N=12,756). Researchers identified OAC medication at cancer diagnosis and the subsequent year, and documented the frequency of quitting or switching between warfarin and direct oral anticoagulants (DOACs). They also discussed the baseline factors linked to OAC non-persistence. One-third of the cancer patients received no OAC medication, while 42% received warfarin and 24% received DOAC therapy. Within one year, the rate of switching between OACs was greater in individuals getting warfarin therapy (8.6%) than in those receiving DOAC medication (1.7%). Warfarin treatment was discontinued at a rate of 61%, whereas DOAC treatment was discontinued at a rate of 26%. 

Females were less likely than males to cease DOAC (ratio 0.77, 95% CI: 0.66, 0.90). DOAC discontinuation was connected with increasing cancer stage, but not with warfarin discontinuation. Two-thirds of patients with newly diagnosed cancer utilized OAC for stroke prevention in AF. Switching between OACs and cessation were more prevalent with warfarin than with DOACs, and females were more persistent with DOACs.

Reference:onlinelibrary.wiley.com/doi/10.1111/bjh.18060