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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}

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Commentary on: EINSTEIN-PE Investigators, OpenUrlCrossRefPubMedWeb of Science


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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  • Competing interests AN has received lecture fees from Boehringer Ingelheim, served on an advisory board for Boehringer Ingelheim and received travel fees from Boehringer Ingelheim, Daiichi Sankyo and Pfizer.