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  • Oral rivaroxaban for acute DVT, or long term for VTE, is as effective as enoxaparin followed by a vitamin K antagonist for preventing recurrence, with no increase in bleeding complications

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Therapeutics
Randomised controlled trial
Oral rivaroxaban for acute DVT, or long term for VTE, is as effective as enoxaparin followed by a vitamin K antagonist for preventing recurrence, with no increase in bleeding complications
  1. David J Rosenberg1,
  2. Jack Ansell2
  1. 1Department of Medicine, Hofstra North Shore-LIJ, North Shore University Hospital, Manhasset, NY, USA
  2. 2Department of Medicine, North Shore LIJ Health System, Lenox Hill Hospital, NY, USA
  1. Correspondence to David J Rosenberg
    North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA; drosenbe{at}nshs.edu

https://doi.org/10.1136/ebm1301

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    Commentary on: Bauersachs R, Berkowitz SD, Brenner B, et al. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010;363:2499–510.OpenUrlCrossRefPubMedWeb of Science

    Context

    Venous thromboembolism (VTE) is a common and costly disorder. Limitations of current treatment options include the need for a multidrug regimen (parenteral and oral), labour-intensive monitoring and frequent adverse events. Rivaroxaban is an investigational, oral, direct factor Xa inhibitor. It provides effective VTE prevention in hip and knee replacement1,–,4 and stroke prevention in atrial fibrillation.5 This article reports the results of two rivaroxaban trials: treatment of acute deep vein thrombosis (DVT) and long-term treatment of DVT or pulmonary embolism (PE) after initial therapy.

    Methods

    The acute DVT study is a randomised, open label non-inferiority trial comparing rivaroxaban with standard therapy for acute, symptomatic, proximal DVT. Participants received rivaroxaban 15 mg twice daily for 3 weeks, then …

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    Footnotes

    • Competing interests DR has served on speakers bureau of Sanofi Aventis, has received research grant support from Sanofi Aventis and serves on an advisory board for Canyon Pharmaceuticals. JA has served as a consultant for Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo and Ortho McNeil.