Please login to the form below

Not currently logged in
Email:
Password:

Xarelto beats aspirin for recurrent blood clots

Trial shows the NOAC reduces the risk of blood clots by 74%

Xarelto

A new phase III trial shows that Bayer and Janssen's novel oral anticoagulant (NOAC) Xarelto is more effective than aspirin at preventing recurrent blood clots, with no increase in bleeding risk.

The results of the EINSTEIN CHOICE trial looked at the value of extended treatment of patients with venous thromboembolism (VTE). It's already known that after an initial few months of anticoagulant treatment for VTE, giving aspirin as a maintenance therapy reduces the risk of recurrence. The new trial results now show - for the first time - that a NOAC is even more effective.

The trial compared Xarelto (rivaroxaban) at a dose of 10mg or 20mg daily with the standard maintenance dose of aspirin (100mg) in VTE patients who had completed six to 12 months of anticoagulation therapy.

After around one year of follow-ups, Xarelto reduced the risk of a recurrent blood clot by 74% for the 10mg dose and 66% for the 20mg dose compared to aspirin, with no difference in serious bleed rates between the groups. The results were presented at the American College of Cardiology (ACC) meeting in Washington DC by Philip Wells of the University of Ottawa and was simultaneously published in the New England Journal of Medicine.

Janssen's parent company Johnson & Johnson (J&J) said in a statement that up to 10% of people who have suffered a VTE (usually a deep vein thrombosis or pulmonary embolism) go onto have a second clot within a year of stopping treatment. The rate increases to one in five patients within three years.

While clinical guidelines already recommend treatment with an anticoagulant for three months or longer, EINSTEIN CHOICE gives a clear indication of the benefit of extended treatment.

"How best to extend anticoagulant use beyond the initial treatment window has been a constant source of debate, with physicians carefully balancing patients’ risk of another VTE with the risk of anticoagulant-related bleeding," said Wells.

"These important results have the potential to trigger a paradigm shift in how physicians manage their patients and protect them from VTE recurrence over the long term."

The results could therefore provide a boost to the position in the NOAC market held by Xarelto, which according to IMS Health figures had 46.5% of the market ahead of rival NOAC Eliquis (apixaban) from Pfizer and Bristol-Myers Squibb (BMS) with 42.5%, well ahead of third place Pradaxa (dabigatran) from Boehringer Ingelheim and Daiichi Sankyo's new entrant Savaysa (edoxaban).

Xarelto has slipped from a 60%-plus market share, however, with Eliquis gaining ground in part because of a debate about Xarelto's role in stroke prevention and the design of the pivotal ROCKET-AF study, although that issue now seems to have been laid to rest with the EU and US regulatory affirming the validity of the trial.

Meanwhile, the overall NOAC market is growing strongly in the face of a string of new studies showing the new drugs' benefits over older anticoagulants such as warfarin.

Article by
Phil Taylor

20th March 2017

From: Research

Share

Tags

Featured jobs

Subscribe to our email news alerts

PMHub

Add my company
Publicis Resolute

Publicis Life Brands Resolute provides real-life practical solutions to your issues, without fuss or fluff. We are an experienced team...

Latest intelligence

How Can We Make Payer Communications Really Sing?
With so many different influences at play in access decisions, how can we make sure we tap into what’s really driving payer decision-making. How do we go beyond the stated...
Harnessing the power of core elements to optimise market access
This article by John Spoors and Anton Abrahams focuses on optimising market access – the RJW and Solaris Health teams operate across all major markets, where the principles set out...
So how do you really engage with patients?
The most valuable insights from patient engagement are the most unexpected ones. Simple things, which may seem unimportant to you, may be the key to making patients’ lives easier and...

Infographics