利伐沙班在治疗静脉血栓这方面效果如何？

At the 66th Annual Scientific Meeting of the American College of Cardiology (ACC2017), Dr. Philip Stephen WELLS, professor and chair of the Department of Medicine at The Ottawa Hospital in Canada, compared the long-term treatment effect and safety of different doses of rivaroxaban (Xarelto, 20 mg, 10 mg) and aspirin on venous thromboembolism. The results of this study were published in the NEJM journal.

This study aimed to compare the clinical efficacy and safety of daily antithrombotic therapy with 20 mg, 10 mg of rivaroxaban (Xarelto, Xarelto), and 100 mg of aspirin for 12 months. In a randomized, double-blind, controlled study, the clinical trial was divided into 3 groups. The first group of 1107 patients took 20 mg of rivaroxaban (Xarelto, Xarelto), the second group of 1127 patients took 10 mg of rivaroxaban (Xarelto, Xarelto), and the third group of 1131 patients took 100 mg of aspirin. These patients had completed 6 to 12 months of initial anticoagulation therapy. 

After 12 months of continuous use, the recurrence rate of venous thrombosis in the aspirin group was 4.4%. The recurrence rates of rivaroxaban (Xarelto, Xarelto) 20 mg and 10 mg were significantly lower than those in the aspirin group, which were 1.5% and 1.2% respectively. Comparing the three groups, there were very few patients who experienced severe bleeding after taking the drug, which were 0.3%, 0.4% and 0.5% respectively. There was no statistical difference between the three groups. The clinically relevant non-bleeding events between the 3 groups were 2.7, 2.0, and 1.8 respectively, and there was also no statistical difference. Therefore, the Dr. Phil Wells research team concluded that for patients with venous thrombosis who have completed 6 to 12 months of treatment and need to continue treatment and who are clinically in equilibrium, using rivaroxaban (Xarelto, Xarelto) 20 mg or 10 mg as a continuous anticoagulant treatment for venous thromboembolism is more effective than 100 mg aspirin, with a significantly lower recurrence rate than aspirin, and does not increase the incidence of bleeding. They also demonstrated the feasibility of a low dose (10 mg) in the treatment of venous thromboembolism.