Exploring unmet needs in venous and arterial thromboembolism with rivaroxaban

Riccardo Cappato; Robert Welsh

doi:10.1160/TH16-06-0484

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2016; 116(S 02): S2-S12
DOI: 10.1160/TH16-06-0484

Thrombosis and Haemostasis Supplement

Schattauer GmbH

Exploring unmet needs in venous and arterial thromboembolism with rivaroxaban

Riccardo Cappato

¹Arrhythmia and Electrophysiology Research Center, Humanitas Clinical and Research Center, Rozzano, Italy

,

Robert Welsh

²Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada

› Author Affiliations

Abstract

Summary

The vast clinical research programme for the direct, oral factor Xa inhibitor rivaroxaban has generated a wealth of data since the first rivaroxaban approval in 2008 for the prevention of venous thrombo embolism (VTE) in patients undergoing elective hip or knee replacement surgery. While rivaroxaban is widely used across a spectrum of seven indications, there is continuous commitment to investigating its wider benefits in new indications and attempts to refine current evidence. Key data from recently completed randomised controlled trials (RCTs) have shown that rivaroxaban is a feasible anticoagulation option for patients with non-valvular atrial fibrillation (NVAF) undergoing cardioversion or catheter ablation. Now, a number of Phase II and III RCTs are underway that seek to uncover further roles for rivaroxaban in patients at risk of thrombosis and aim to improve quality of life. This article will introduce and provide context for these RCTs in the contemporary management of arterial and venous thromboembolism in the following underserved areas: Patients with both NVAF and acute coronary syndrome (ACS) requiring percutaneous coronary intervention (PCI); patients with embolic stroke of undetermined source (ESUS); patients who require transcatheter aortic valve replacement (TAVR); patients with acute or chronic coronary artery disease (CAD; including those with heart failure [HF]); those at risk of or suffering from cancer-associated thrombosis (CAT) and those requiring long-term anticoagulation. It is hoped that this collection of studies provides clarity around the use of rivaroxaban as a fundamental component of antithrombotic therapy in an array of clinical situations.

Keywords

Rivaroxaban - acute coronary syndrome - atrial fibrillation - venous thromboembolism - transcatheter aortic valve replacement

Full Text

References

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