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EINSTEIN CHOICE: Rivaroxaban Beats Aspirin for VTE Recurrence

In patients with venous thromboembolism (VTE) who had completed 6 to 12 months of anticoagulation therapy but for whom it was uncertain as to whether longer-term treatment was needed, extended therapy with rivaroxaban (Xarelto, Bayer/Janssen Pharmaceuticals) at either 20 mg or 10 mg was more effective than aspirin at preventing recurrent VTE without an increased risk of bleeding in the EINSTEIN CHOICE trial.

The trial was presented at the American College of Cardiology (ACC) 2017 Scientific Sessions and simultaneously published online in the New England Journal of Medicine.

According to Dr Philip S Wells (University of Ottawa, ON) in his presentation, clinicians could safely prescribe rivaroxaban for prevention of recurrent VTE without concern for increased risk of bleeding.

He explained that patients who have had a VTE are generally treated with an anticoagulant for 6 to 12 months after the event. However, some patients remain at elevated risk for recurrent VTE, as well as MI or stroke, if anticoagulant therapy is stopped.

Previous studies have suggested that extended treatment with an anticoagulant such as warfarin or rivaroxaban reduced risk for a recurrent VTE, while other studies have shown that aspirin also reduced risk for a recurrent VTE and might present a lower risk for bleeding side effects than extended treatment with an anticoagulant. This study was the first to directly compare the safety and effectiveness of rivaroxaban and aspirin in patients at risk for a recurrent VTE.

http://www.medscape.com/viewarticle/877400