{"id":"829168ec973c","type":"article","url":"https://hartvaat.nl/2026/01/01/rivaroxaban-discontinueringspercentages-bij-niet-valvulair-af-in-de-italiaanse-p/","title":"Rivaroxaban-discontinueringspercentages bij niet-valvulair AF in de Italiaanse praktijk","title_en":"Rivaroxaban treatment discontinuation rates in patients with nonvalvular atrial fibrillation in Italian clinical practice: RITMUS-AF.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["apotheker","cardioloog","huisarts"],"tags":["rivaroxaban"],"journal":"PloS one","doi":"10.1371/journal.pone.0341633","source_url":"https://doi.org/10.1371/journal.pone.0341633","authors":["Carmine Pizzi","Leopoldo Pagliani","Luca Dalle Carbonare","Piergiuseppe Agostoni","Egidio Imbalzano","Gennaro Galasso","Gianni Casella","Nicolò Dasseni","Leonardo De Luca","Italo Porto","Biagio Sassone","Davide Tosarello","Pareen Vora","Claudia Erminero","Giovanni Battista Forleo","Paolo Fusco","Ciro Mauro","Francesco Milone","Gian Piero Perna"],"significance":4,"published":"2026-01-01","source_date":"2026-01-01","image":"https://hartvaat.nl/global/img/1eafc516f825.webp","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/","https://hartvaat.nl/kennis/atriumfibrilleren/af-en-beroerte/"],"congress":"","summary_en":"The RITMUS-AF prospective study documented rivaroxaban discontinuation rates in Italian clinical practice among patients with non-valvular atrial fibrillation. Approximately 20% of patients discontinue DOAC therapy within the first year.","created":"2026-07-03T10:25:36Z","updated":"2026-07-03T13:25:00Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Non-adherentie aan DOAC-therapie verhoogt het risico op ischemische beroerte bij niet-valvulair AF. Circa 20% van de patiënten staakt de behandeling. Deze RITMUS-AF-studie onderzocht de discontinueringspercentages van rivaroxaban in de Italiaanse klinische praktijk.","abstract_original":"Nonadherence to direct oral anticoagulant (DOAC) therapy exposes patients with nonvalvular atrial fibrillation (NVAF) to an increased risk of ischemic stroke and systemic embolism. Nevertheless, approximately 20% of patients discontinue treatment within the first year. In Italy, data on DOAC discontinuation rates are limited, especially in high-risk populations. RITMUS-AF, a prospective, observational cohort study conducted in 31 centers across Italy, investigated rivaroxaban treatment discontinuation in patients with NVAF in routine clinical practice. It included 805 patients aged ≥18 years with NVAF who were newly initiated on rivaroxaban. The primary endpoint was the proportion of patients who discontinued treatment during a 24-month follow-up. Secondary endpoints included the reasons for discontinuation and self-reported adherence to rivaroxaban therapy. At baseline, most patients were oral anticoagulant (OAC)-naïve (n = 599, 74.4%) and had either symptomatic (n = 364, 45.2%) or asymptomatic (n = 441, 54.8%) NVAF. The overall rate of rivaroxaban discontinuation was 8.9 per 100 patient-years (95% CI: 7.1-11.0). The main reasons for discontinuation were adverse events or physician decisions. After 24 months, high adherence was reported in 90.9% of OAC-non-naïve patients and 61.5% of OAC-naïve patients. Forty-six patients (5.7%) experienced bleeding events (with major bleeding events occurring in <0.5% of cases), and one patient (0.1%) had an ischemic stroke. In the RITMUS-AF study, rivaroxaban treatment was associated with a low treatment discontinuation rate, along with high self-reported adherence and a relatively low incidence of ischemic stroke and bleeding events in a high-risk population, findings that may help inform clinical decision-making on the use of rivaroxaban in routine practice."}