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Archive for the ‘Xarelto (Rivaroxaban)’ Category

Handout for Your Patients in Clinic – Which Anticoagulant to Use for DVT and PE

| Anticoagulants, Deep Vein Thrombosis (DVT), Eliquis, Pradaxa (dabigatran), Pulmonary Embolism, Uncategorized, Warfarin (Coumadin), Xarelto (Rivaroxaban) | Comments Off on Handout for Your Patients in Clinic – Which Anticoagulant to Use for DVT and PE

Stephan Moll, MD writes…  Patients who are on warfarin for a history of DVT or PE  may inquire whether a switch to one of the  new oral anticoagulants is appropriate.  Similarly, many physicians initiate this discussion with their patients.

This is, obviously, a detailed discussion and an individualized decision with a number of factors to be considered.  We have developed a two-page “Comparison of Oral Blood Thinners”  handout for patients, to assist with and summarize the discussion.  This sheet allows a structured  discussion with the patient about the pros and cons of the various anticoagulant choices.  The reader is welcome to print this resource and use it as a handout for his/her patients.

Disclosure:  I have been a consultant for  Boehringer-Ingelheim, Daiichi, and Janssen.

Last Updated:  Dec 19th, 2013

NEJM Publication: Edoxaban for VTE Treatment

| Anticoagulants, Eliquis, Pradaxa (dabigatran), Therapy, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on NEJM Publication: Edoxaban for VTE Treatment

Stephan Moll, MD writes…  Today, Sept 1st, 2013, the New England Journal of Medicine published the phase 3 clinical trial of edoxaban versus warfarin in the treatment of DVT and PE [ref 1]. It showed that edoxaban was as effective as warfarin and led to less clinically relevant bleeding. Read the rest of this entry »

New Oral Anticoagulants for DVT and PE: Update on FDA Applications

| Eliquis, Pradaxa (dabigatran), Uncategorized, Xarelto (Rivaroxaban) | Comments Off on New Oral Anticoagulants for DVT and PE: Update on FDA Applications

Stephan Moll, MD writes…

 

1.  Pradaxa (Dabigatran)

  • Today, August 28th, 2013, it was announced that the FDA is reviewing the application by Boehringer-Ingelheim to get Pradaxa (dabigatran) approved for use in patients with deep vein thrombosis (DVT) and pulmonary embolism (PE) – details here.
  • At present, in the US, Pradaxa is only FDA-approved for prevention of stroke and other arterial clots in patients with irregular heart beat.

2.  Eliquis (Apixaban)

  • On July 11th , 2013 the company making Eliquis applied for FDA approval of their drug for DVT and PE prevention after hip and knee replacement surgery – details here.
  • The company has not yet filed for approval of the drug for DVT and PE treatment.
  • At present, in the US, Eliquis is only FDA-approved for prevention of stroke and other arterial clots in patients with irregular heart beat.

3.  Xarelto (Rivaroxaban)

  • Xarelto is, at present the only one of the new oral anticoagulants that is FDA-approved for the treatment of DVT and PE.  It is also approved for (a) DVT and PE prevention after hip and knee replacement surgery, and (b) for prevention of stroke and other arterial clots in patients with irregular heart beat.

4.  Edoxaban

  • This new oral anticoagulant by the Japanese company Daiichi is not FDA-approved at this time and no FDA review of data is pending.

 

Disclosure:  I have consulted for Janssen, Daiichi, Boehringer Ingelheim.

Last updated: Sept 1st, 2013

International Coagulation Meeting (ISTH 2013): Highlights

| Anticoagulants, Deep Vein Thrombosis (DVT), Eliquis, Inherited, Pradaxa (dabigatran), Pulmonary Embolism, Therapy, Thrombophilias, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on International Coagulation Meeting (ISTH 2013): Highlights

Stephan Moll, MD writes…  A major international coagulation conference, the bi-annual meeting of the International Society for Thrombosis and Haemostasis (ISTH; www.isth.org), took place in Amsterdam, Holland, from June 29th to July 4th, 2013.  The clinically relevant highlights about thrombosis and anticoagulation are summarized below. Read the rest of this entry »

Top 10 Publications on Thrombosis and Anticoagulation from 2012

| Arterial Clots, Aspirin, Plavix, Aggrenox, Tiklid, Persantine, Deep Vein Thrombosis (DVT), Eliquis, Other topics, Pradaxa (dabigatran), Pulmonary Embolism, Uncategorized, Venous Clots, Warfarin (Coumadin), Xarelto (Rivaroxaban) | Comments Off on Top 10 Publications on Thrombosis and Anticoagulation from 2012

Stephan Moll writes…

2012 has been a year with significant progress in the field of venous thromboembolism and anticoagulation.  The three most noteworthy, clinically relevant developments were probably (a) the publication of the new ACCP (American College of Chest Physician) guidelines on antithrombotic therapy in February 2012; (b)  The FDA-approval of rivaroxaban (Xarelto) in November 2012 for the acute treatment of venous thromboembolism (VTE) and long-term secondary prevention; and (c) The FDA-approval of apixaban (Eliquis) in December 2012 for atrial fibrillation and the prevention of arterial thromboembolism.  Here I have listed and summarized the 10 top publications of 2012  in the field of venous thromboembolism and anticoaguation as I see them – the ones clinically most relevant. 

 

Disclosure: I have consulted for Janssen, Boehringer-Ingelheim and Daiichi.

Last updated: Feb 7th, 2013

 

Xarelto (Rivaroxaban) – Hospital Guideline

| Anticoagulants, Therapy, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on Xarelto (Rivaroxaban) – Hospital Guideline

Stephan Moll, MD writes…

Xarelto® is FDA approved for treatment of venous thromboembolism (VTE), prevention of VTE after hip and knee replacement  surgery, and for atrial fibrillation.   A number of practical management questions are encountered by physicians, pharmacists, and other health care professional taking care of patients on Xarelto®, such as (a) dosing in renal impairment, (b) conversion of a patient on warfarin to Xarelto®, (c) discontinuation of Xarelto® at times of surgery, dental procedures, colonoscopy, and other procedures, and (d) management of bleeding on Xarelto®.   These issues may best be addressed in a health care system by the establishment of a structured treatment algorithm/guide/help for the entire hospital or physician practice. Read the rest of this entry »

Xarelto (Rivaroxaban): FDA Approved for DVT and PE Treatment

| Anticoagulants, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on Xarelto (Rivaroxaban): FDA Approved for DVT and PE Treatment

Stephan Moll, MD writes…

Today is a very exciting day for patients and health care professionals: the oral anticoagulant Xarelto® (rivaroxaban) was FDA approved today (Nov 2nd, 2012) for the use in patients with DVT and PE – for the acute treatment of DVT and PE, as well as for the secondary long-term prevention of recurrent venous thromboembolism (VTE). The FDA announcement can be read, here. Why is this exciting? Because therapy with Xarelto is much easier for patients and health care professionals than the often cumbersome therapy with warfarin.

Read the rest of this entry »

Rivaroxaban (Xarelto) and PE

| Anticoagulants, Therapy, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on Rivaroxaban (Xarelto) and PE

Stephan Moll, MD writes…

Good news: The large phase 3 clinical trial comparing 3-12 months treatment of Rivaroxaban (Xarelto) with warfarin in patients with newly diagnosed pulmonary embolism was published on 3-26-2012 in the New England Journal of Medicine [reference 1], showing that Rivaroxaban was (a) noninferior to warfarin in its efficacy, (b) caused the same amount of clinically relevant bleeding (composite of major and clinically relevant nonmajor bleeding), and (c) caused less major bleeding Read the rest of this entry »