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Updated: May 15, 2026
11:17
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Rivaroxaban: an oral factor Xa inhibitor
Tyan F Thomas1, Valerie Ganetsky, Sarah A Spinler
1Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, Philadelphia, Pennsylvania.
Clinical Therapeutics
|January 19, 2013
Summary
Rivaroxaban offers effective venous thromboembolism (VTE) prevention after orthopedic surgery and stroke prevention in atrial fibrillation (AF). However, increased bleeding risk limits its use for secondary prevention after acute coronary syndromes (ACS).
Area of Science:
- Pharmacology and Therapeutics
- Cardiovascular Medicine
- Hematology
Background:
- Current anticoagulants for venous thromboembolism (VTE) and atrial fibrillation (AF) stroke prevention have limitations like injections and lab monitoring.
- Rivaroxaban, an oral Factor Xa inhibitor, presents an alternative for VTE prevention, stroke prevention in AF, and VTE treatment.
Purpose of the Study:
- To review the pharmacology, efficacy, and tolerability of rivaroxaban.
- To evaluate rivaroxaban's use in VTE prophylaxis, stroke prevention in AF, adjunctive therapy in acute coronary syndromes (ACS), and VTE treatment.
Main Methods:
- Searched International Pharmaceutical Abstracts, EMBASE, and PubMed for English-only clinical trials and reviews.
- Included studies published between 1970 and June 2012, identifying additional trials from citations.
Main Results:
- Rivaroxaban demonstrated non-inferiority to enoxaparin for VTE prophylaxis post-orthopedic surgery.
- It was non-inferior to vitamin K antagonists for stroke prevention in nonvalvular AF and VTE treatment.
- Rivaroxaban showed a benefit in reducing major adverse cardiovascular events post-ACS, but with higher bleeding rates in specific contexts.
Conclusions:
- Rivaroxaban is an effective option for VTE prevention post-orthopedic surgery, stroke prevention in nonvalvular AF, and VTE treatment.
- Current evidence does not support rivaroxaban for secondary risk reduction post-ACS due to elevated bleeding risk.
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