Evid Based Med 18:29-30 doi:10.1136/eb-2012-100789
  • Therapeutics
  • Randomised controlled trial

Oral treatment of acute pulmonary embolism with a fixed dose of rivaroxaban is non-inferior to standard treatment

  1. Alexander Niessner
  1. Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
  1. Correspondence to: Professor Alexander Niessner
    Waehringer Guertel 18–20, Vienna 1090, Austria; alexander.niessner{at}

Commentary on: EINSTEIN-PE Investigators,


Pulmonary embolism (PE) is a common disease with potentially life-threatening consequences. Current guidelines1 recommend immediate start of anticoagulation with heparin for at least 5 days. Thereafter, heparin may be replaced by vitamin K antagonists (VKAs). The EINSTEIN-PE study tested rivaroxaban for the treatment of acute PE. Rivaroxaban, an oral anti-Xa antagonist, has the major advantage of oral administration with a fixed dose. This drug has been tested so far for thromboprophylaxis after orthopaedic surgery and for patients with atrial fibrillation. The applied therapeutic regimen of rivaroxaban was also already tested for acute deep-vein thrombosis (DVT) in the EINSTEIN-DVT trial.2


A total of 4832 adult patients with acute symptomatic PE were included in …

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