Abstract
Bucolome, a nonsteroidal antiinflammatory drug, has often been coadministered with warfarin in order to augment its anticoagulant effect and reduce the dose of warfarin in anticoagulation therapy in patients with atrial fibrillation. However, there is little information on the use of bucolome and its influence on warfarin dose in actual clinical practice in Japan. We therefore investigated the frequency of the coadministration of bucolome in 6932 patients who were enrolled in the J-RHYTHM Registry and receiving warfarin at the time of registry in 2009. We evaluated the relationship between these rates and warfarin doses in 158 institutions and 10 geographical divisions.
Combinations of bucolome and warfarin were prescribed to 297 (4.3%) patients at 64 (40.5%) institutions. Warfarin dose in patients with bucolome coadministration was almost half and less than that in monotherapy patients (1.4±0.7mg/day vs. 2.9±0.4mg/day, p<0.001). There were large differences in the rates of bucolome use among institutions (0−88.9%) and among divisions (0.3−27.3%). Rates of bucolome use were negatively correlated with the average doses of warfarin in institutions (r=−0.59, p<0.001) and in divisions (r=−0.71, p=0.021).
Coadministration of bucolome certainly contributed to reduction in warfarin dose. However, large differences among institutions and among divisions were found in rates of bucolome use. Since the total number of patients using bucolome was small, bucolome use did not affect the overall average warfarin dose except in the Hokuetsu division.
