利伐沙班对静脉血栓的疗效

(Xarelto) is a highly selective, oral drug that directly inhibits factor xa. By inhibiting factor xa, the endogenous and exogenous pathways of the coagulation cascade can be interrupted, and the generation of thrombin and thrombosis can be inhibited. Rivaroxaban does not inhibit thrombin and has no proven effect on platelets. Today we will learn more about the efficacy of rivaroxaban on venous thrombosis.

EINSTEIN-Jr is a randomized, open-label Phase III study enrolling 500 pediatric patients (birth to 17 years) diagnosed with acute VTE who were initiated on heparin therapy. Pediatric patients received open-label, weight-adjusted dose Xarelto (n = 335, tablet or suspension) or standard anticoagulant therapy (n = 165, unfractionated heparin, low-molecular-weight heparin, fondaparinux, or a switch to a vitamin K antagonist) in a 2:1 ratio. The treatment period is 3 months, except for children under 2 years of age with catheter-related VTE who receive 1 month of treatment. Repeat imaging was performed at the end of treatment.

The results showed that the study met all pre-specified endpoints: recurrent VTE events were similar in the 2 groups, and slightly lower in the rivaroxaban (Xarelto) treatment group (recurrent VTE event rate: 1.2% [n=4] vs 3.0% [n=5]; HR=0.40, 95%CI: 0.11-1.41), and there were no fatal VTE events in either treatment group.

An international scientific research team published a paper in the journal "The Lancet" stating that through analysis of data from a multi-center, randomized, double-blind clinical trial called "BECORD4", among a total of more than 3,000 patients, researchers confirmed that compared with standard therapy using enoxaparin, patients treated with rivaroxaban (Xarelto) reduced the risk of venous thromboembolism after orthopedic surgery by about one-third. "This is the first oral anticoagulant drug with better efficacy than the current standard therapy, so it may become a new clinical treatment option for preventing severe blood clots after major orthopedic surgery," said Professor A. Turpai from McMaster University in Canada. "At the same time, this new drug also has good economics."

Rivaroxaban (Xarelto) is produced by Bayer Healthcare GmbH. It is mainly used clinically to prevent the formation of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients after hip and knee replacement surgery. It can also be used to prevent stroke and non-central nervous system embolism in patients with non-valvular atrial fibrillation, and reduce the risk of recurrence of coronary syndrome.

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