Is Rivaroxaban On The Way Out?
Anything rivaroxaban can do, can apixaban do it better?
There have been clues apixaban carries a slightly lower bleeding risk than rivaroxaban, but, for the most part, the direct oral anticoagulants are mostly considered interchangeable.
In Canada, to treat patients with acute venous thromboembolism:
And no difference between arms as far as recurrent VTE during the treatment period.
Rivaroxaban is frequently chosen because of its simplified once-a-day dosing, and this is apparent in the adherence statistics gathered:
In spite of this limitation, apixaban retained its effectiveness in treating and preventing recurrent VTE.
These data include only patients <120kg, and only treatment of uncomplicated acute VTE – there are many other indications and permutations for DOACs, and these don’t automatically generalize to all of them. It will be interesting to see those follow-up studies as they materialize.