Number needed to treat for net effect of anticoagulation in atrial fibrillation: Real-World vs. Clinical Trial Evidence
Post-hoc analysis demonstrated potential clinical applicability of the NNT for net benefit approach; the Calculator of Absolute Stroke Risk was used to show that the NNTnet of anticoagulation therapy at 1-year was 34 in a real-world cohort and 46 in a clinical trial population.
Source:
British Journal of Clinical Pharmacology
SPS commentary:
The NNT to prevent one ischaemic stroke event was 25 (real-world) and 27 (clinical trial); and to contribute to one major bleeding event was 100 (real-world) and 63 (clinical trial).
The NNTnet approach in AF incorporates information regarding baseline risk of stroke and major bleeding, and relative effects of oral anticoagulation with the potential to include multiple additional outcomes and weighting of events based on their perceived effects by individual patients. The researchers suggest that this simple and intuitive metric may be useful to improve communication and optimise the patient-centred management of AF.