Arterial and venous thromboembolic diseases are a clinical and economic burden worldwide. In addition to traditional agents such as
vitamin K antagonists and heparins, newer oral agents - such as the
factor Xa inhibitors rivaroxaban,
apixaban, and
edoxaban, and the
direct thrombin inhibitor dabigatran - have been shown to be effective across several indications.
Rivaroxaban has been shown to have predictable pharmacokinetic and pharmacodynamic properties, including a rapid onset of action. In addition, there is no requirement for routine coagulation monitoring; and no dose adjustment is necessary for age alone, sex, or
body weight.
Rivaroxaban has successfully met primary efficacy and safety endpoints in large, randomized phase III trials across several indications, including: prevention of
venous thromboembolism in orthopedic patients undergoing elective hip or knee replacement surgery; treatment of
deep vein thrombosis and
secondary prevention of
deep vein thrombosis and
pulmonary embolism;
stroke prevention in patients with
atrial fibrillation; and
secondary prevention of
acute coronary syndrome.
Rivaroxaban and the other newer oral
anticoagulants are likely to improve outcomes in the prevention and treatment of thromboembolic events, and will offer patients and physicians alternative treatment options.