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Did Regional Differences Muddy Results in COMMANDER-HF?

February 04, 2021 Geographical differences in treatment uptake among participants in the COMMANDER-HF trial may muddy the interpretation of the study, which ultimately saw no impact of rivaroxaban on the primary outcome in the overall trial, a new analysis suggests. “These differences were most marked in Eastern European countries that presented lower event rates and treatment adherence,” write João Pedro Ferreira, MD, PhD (Université de Lorraine, Nancy, France), and colleagues in a paper published online February 3, 2021 in JACC: Heart Failure. Ferreira and colleagues believe the findings have implications for future global drug trials, which they say “should require objective inclusion criteria that are less prone to investigator interpretation, ensure that financial incentives to recruitment are carefully controlled, and confirm that participants are aware of the consequences for others if they are nonadherent without good reason.”

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