How Effective is Xarelto?


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Xarelto (rivaroxaban) is effective at treating and preventing blood clots in people with conditions like atrial fibrillation (AFib), deep vein thrombosis (DVT) and pulmonary embolism (PE).

It is also effective at reducing the risk of major cardiovascular events such as cardiovascular death, myocardial infarction (MI) and stroke in patients with coronary artery disease (CAD) and peripheral artery disease (PAD).

As seen on DailyMed, a website created and operated by the U.S. National Library of Medicine, Xarelto's efficacy has been evaluated and proven in numerous clinical studies.

Xarelto for Stroke Prevention in Nonvalvular AFib

Xarelto's effectiveness at preventing stroking in people with nonvalvular AFib was analyzed in a mutli-national double-blind study called ROCKET AF. The study was designed to test whether Xarelto could achieve more than 50 percent of warfarin's effect. This type of study is known as a non-inferiority study.

ROCKET AF followed a total of 14,264 patients over a median time period of 590 days. The median age of 71 years and 60 percent of patients were male. Most patients resided in either Eastern Europe (39 percent) or North America (19 percent).

The study concluded that Xarelto is not inferior to warfarin, though it wasn't proven to be superior either. Both Xarelto and warfarin significantly lengthened the amount of time patients could go without suffering a stroke.

Xarelto for Treating DVT and/or PE

Xarelto's effectiveness for treating DVT and/or PE was observed in two multi-national, open-label, non-inferiority studies. The studies were called EINSTEIN DVT and EINSTEIN PE, and both aimed to determine whether Xarelto is or is not inferior to enoxaparin.

Across the two studies, a total of 8,281 patients were followed for a mean time period of 208 days. The mean age was about 57, and 55 percent of patients were male.

In both studies, Xarelto was found to be non-inferior to enoxaparin, but was not proven to be superior.

Both Xarelto and enoxaparin reduced the amount of time it took for patients to experience their first recurrent DVT or PE (either fatal or non-fatal) from the EINSTEIN DVT study's starting point.

Xarelto for the Prevention of DVT After Hip or Knee Replacement Surgery

Three randomized, double-blind studies called RECORD 1, 2 and 3 evaluated Xarelto's efficacy at preventing DVT in patients following hip or knee replacement surgery compared to that of enoxaparin.

The RECORD 1 and RECORD 2 studies examined patients undergoing total hip replacement surgery. A total of 6,579 patients were given either Xarelto or enoxaparin.

Patients' mean age was 63, with 49 percent being 65 years of age or older. The majority (55 percent) of patients were female.

During the studies, patients were exposed to Xarelto for a mean time period of 33.5 days, while patients taking enoxaparin were exposed to the drug for a mean time period of 12.4 days.

The results proved that Xarelto is much more effective than enoxaparin at preventing venous thromboembolism (VTE, otherwise known as blood clots in the leg, groin or arm) after total hip replacement surgery.

In RECORD 1, 1.1 percent of patients taking Xarelto developed VTE, compared to 3.9 percent of those taking enoxaparin. In RECORD 2, two percent of patients taking Xarelto developed VTE, compared to 8.4 percent of those taking enoxaparin.

Meanwhile, the RECORD 3 study examined patients undergoing total knee replacement surgery.

A total of 1,684 patients were studied, with 813 given Xarelto and 871 given enoxaparin. The mean patient age was 68, with 66 percent of patients being 65 years of age or older. Sixty-eight percent of patients were female.

Patients were exposed to Xarelto for a mean time period of 11.9 days, while those taking enoxaparin were exposed to it for a mean time period of 12.5 days.

Once again, the results found Xarelto to be markedly more effective than enoxaparin. Only 9.7 percent of patients taking Xarelto developed VTE, compared to 18.8 percent of those taking enoxaparin.

Xarelto for Reducing the Risk of Major Cardiovascular Events

A double-blind study called COMPASS examined the efficacy and safety of Xarelto for the reduction of major cardiovascular events (stroke, MI or cardiovascular deaths) in patients with chronic CAD or PAD.

The study examined a total of 27,395 patients with a mean follow-up duration of 23 months. Patients' mean age was 68, and 21 percent were 75 years of age or more.

COMPASS found that a combination of Xarelto and aspirin was more effective at reducing the risk of major cardiovascular events than aspirin alone.

A combined treatment of Xarelto and aspirin was more successful than just aspiring at lengthening the amount of time before patients' experienced their first major cardiovascular event.

Is Xarelto Right for You?

As with any prescription drug, you can't know if Xarelto is right for you without first consulting your doctor, 

According to Xarelto's official safety information, you should not take Xarelto if you:

  • Currently have certain types of abnormal/unusual bleeding.
  • Have an artificial heart valve.
  • Have antiphospholipid syndrome (APS), particularly with positive triple antibody testing.
  • Are allergic to rivaroxaban or any of Xarelto's other ingredients.

Before taking Xarelto, remember to tell your doctor if you:

  • Have ever experienced bleeding problems.
  • Have liver or kidney problems.
  • Have APS.
  • Are pregnant or planning to become pregnant.
  • Are breastfeeding or planning to breastfeed.

Additionally, be sure to follow storage instructions and to tell your doctor about any prescription medications, over-the-counter medications and/or herbal supplements you take — some may put you at a higher risk for developing serious side effects like bleeding or spinal or epidural blood clots. 

If your doctor does decide that Xarelto is right for you and you can benefit from taking Xarelto, you can save money on your prescription—buy affordable Xarelto from a trustworthy online pharmacy or pharmacy referral service like My Drug Center.

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