Medical Lessons

On the hema­tology front –

Last weekend at the annual meeting of the American Society of Hema­tology (ASH), researchers pre­sented data on a new kind of blood thinner. Rivaroxaban (Xarelto) is a pill that works by blocking the acti­vated form of human clotting factor X (Xa). The NEJM pub­lished the EINSTEIN* findings on-​​​​line ahead of print, coin­cident with the presentation.

The research includes two reported trials. In the first, an open-​​​​label ran­domized study of 3449 patients with acute deep venous throm­bosis (DVT), sub­jects received either rivaroxaban pills or a standard treatment regimen starting with an injected blood thinner (enoxa­parin) fol­lowed by an oral Vitamin K antag­onist, like coumadin. The main findings in this Acute DVT Study was that the new drug, rivaroxaban, is as good (“non-​​​​inferior”) in terms of pre­venting recurrent clot as is the older regimen and bears a similar safety profile.

The second, par­allel EINSTEIN-​​​​extension trial involved randomization

See more Notes On a New Kind of Anticoagulant