Patient-reported treatment satisfaction with oral rivaroxaban versus standard therapy in the treatment of pulmonary embolism; results from the EINSTEIN PE trial

Prins, Martin H.; Bamber, Luke; Cano, Stefan; Wang, Maria Y.; Erkens, Petra M. G.; Bauersachs, Rupert; Lensing, Anthonie W. A.

doi:10.1016/j.thromres.2014.11.008

Cited by 80 publications

(88 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The main disadvantage of rivaroxaban treatment was its cost. Most of our patients, like the subjects from the EINSTEIN-PE trial, appreciated the advantages of rivaroxaban therapy [24].…”

Section: Discussionmentioning

confidence: 90%

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

et al. 2016

View full text Add to dashboard Cite

A b s t r a c t Background:The main goal of treatment in patients with atrial fibrillation is to counteract the effects of embolisation, considering the relatively high risk of cerebral embolic events.Aim: An assessment of the efficacy and safety of rivaroxaban in secondary stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Methods:The study concerned 209 NVAF patients (male/female: 117/92; mean age 65.3 years ), who used rivaroxaban as secondary prevention of cardiogenic stroke. The patients were followed up for 24 months: the control visits were performed 12 and 24 months after the onset of the inclusion. The following aspects were analysed: the occurrence of recurrent stroke and/or transient ischaemic attack (TIA) during rivaroxaban treatment, bleeding episodes with their placement and severity assessment, drug tolerance, and evaluation of the patient's medical records including laboratory tests (e.g. creatinine clearance) and concomitant therapy. All patients underwent physical examination as well as neurological assessment. Results:The mean CHA 2 DS 2 -VASc in the study group was 4.16, and the mean HAS-BLED value was 3.31. During the follow-up 13 deaths were noted (6.22%), ischaemic stroke was diagnosed in five (2.39%) subjects, and TIA in three (1.43%) patients. Bleeding complications were reported in 25 (11.96%) patients, two of which were classified as major bleedings (0.95%): an intracranial bleeding (1) and a bleeding from the genital tract (1). Conclusions:For patients with NVAF and cerebrovascular events, the use of rivaroxaban in a real-world clinical setting results in a highly efficacious treatment profile and acceptable safety.

show abstract

“…The main disadvantage of rivaroxaban treatment was its cost. Most of our patients, like the subjects from the EINSTEIN-PE trial, appreciated the advantages of rivaroxaban therapy [24].…”

Section: Discussionmentioning

confidence: 90%

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In addition to shorter hospital stay which translates to economic benefits of rivaroxaban therapy, higher patient satisfaction was also shown among patients treated with this drug compared to the standard therapy. In a group of 2397 participants of the EINSTEIN PE study, Prins et al [11] showed higher patient satisfaction in the rivaroxaban group compared to the VKA group. Importantly, reduced duration of hospitalisation is associated with lower treatment costs.…”

Section: Resultsmentioning

confidence: 98%

“…Matsuo et al [10] evaluated the duration of hospital stay of 97 patients with VTE, including 78 patients treated with rivaroxaban and 19 patients treated with UFH followed by warfarin. These authors showed a significantly shorter duration of hospitalisation among patients treated with rivaroxaban (10 [6-15] vs. 15 [9][10][11][12][13][14][15][16][17][18][19][20][21][22] days, p = 0.016). In the Polish literature, no data have been previously available on the duration of hospitalisation among APE patients treated with NOAC.…”

Section: Resultsmentioning

confidence: 99%

Acute pulmonary embolism treatment with rivaroxaban results in a shorter duration of hospitalisation compared to standard therapy: an academic centre experience

et al. 2016

View full text Add to dashboard Cite

A b s t r a c tBackground: Depending on the severity of clinical condition, acute pulmonary embolism (APE) is treated with unfractionated heparin (UFH), low-molecular weight heparin (LMWH), oral anticoagulants or, in the most severe form, with fibrinolytic agents. Following APE, patients require prolonged anticoagulant therapy for 3-6 months or in some cases indefinitely. Treatment options in this period include vitamin K antagonists (VKA) and non-VKA oral anticoagulants (NOAC) including rivaroxaban. The most recent European Society of Cardiology guidelines on the diagnosis and management of APE recommend use of NOAC in patients at a low-to-moderate risk of early mortality (a class I B recommendation). Rivaroxaban may be used in haemodynamically stable patients since the first day of therapy and was approved for this indication in Poland in December 2012. Aim:To evaluate the rate of rivaroxaban use, characterise patients with APE treated with rivaroxaban, and evaluate potential reduction of the duration of hospitalisation in patients treated with rivaroxaban compared to those receiving VKA. Methods:We evaluated hospital and postdischarge treatment in 215 consecutive APE patients (105 men, 110 women) at the mean age of 65.0 (range: 19.5-91.9) years. The study included patients hospitalised from January 2013 to November 2014, i.e. in the period immediately following approval of rivaroxaban for the treatment of APE in Poland. In the acute phase, patients were treated with LMWH, UFH, or rivaroxaban, and the treatment was continued with VKA, LMWH, or rivaroxaban. The timing of initiation of oral therapy depended on the haemodynamic stability of the patient.Results: Our study group of 215 APE patients included 157 (73%) moderate-risk patients, 51 (24%) low-risk, and 7 (3.3%) high-risk patients. Treatment was initiated with UFH or LMWH in 208 (96.7%) patients, and with rivaroxaban in 7 (3.3%) patients. In 33 (16.5%) patients, rivaroxaban was started after up to 3 days of heparin therapy. Chronic therapy prescribed at discharge included VKA in 64 (30.5%) patients, rivaroxaban in 82 (39%) patients, and LMWH in 64 (30.5%) patients. Five patients died during hospital, for the total mortality of 2.3%. Acute high-risk PE was diagnosed on admission in 2 of these patients, and moderate-risk PE in 3 patients. Treatment in this group included enoxaparin in 4 patients and UFH in 1 patient. Patients who were discharged on rivaroxaban stayed in hospital for a significantly shorter time compared to patients discharged on VKA ( Conclusions: Rivaroxaban therapy is a useful therapeutic option in patients with APE. Compared to standard therapy, use of rivaroxaban has been associated with a significant reduction of the duration of hospital stay.

show abstract

“…16,17 In Oral Direct Factor Xa Inhibitor Rivaroxaban in Patients With Acute Symptomatic Deep Vein Thrombosis (EINSTEIN-DVT; n = 1472), 13 patients randomized to rivaroxaban reported more favorable ACTS burden scores (55.2 vs 52.6; effect size 0.42; P < 0.0001) compared with enoxaparin/VKA. In the Oral Direct Factor Xa Inhibitor Rivaroxaban in Patients With Acute Symptomatic Pulmonary Embolism (EINSTEIN-PE) trial (n = 2397), 14 patients reported rivaroxaban as being less burdensome than enoxaparin/VKA (55.4 vs 51.9; P < 0.0001).…”

Section: Discussionmentioning

confidence: 99%

Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS‐ACTS Substudy

Coleman

Haas²,

Turpie

et al. 2016

Clinical Cardiology

View full text Add to dashboard Cite

BackgroundThe efficacy, safety, and ease of use of rivaroxaban may reduce anticoagulation‐treatment burden and improve nonvalvular atrial fibrillation (NVAF) patient satisfaction compared with vitamin K antagonists (VKAs).HypothesisTransitioning from a VKA to rivaroxaban improves treatment satisfaction in routine practice.MethodsXarelto for Prevention of Stroke in Patients With Atrial Fibrillation (XANTUS) is a prospective, noninterventional study in patients with NVAF prescribed rivaroxaban for prevention of stroke in routine practice. Patients receiving a VKA 4 weeks prior to the initial XANTUS study visit and switched to rivaroxaban were asked to complete the Anti‐Clot Treatment Scale (ACTS). Changes from the initial visit to the first follow‐up visit at ∼ 3 months (corresponding to a comparison of rivaroxaban vs prior VKA) for ACTS burden and benefit scores were calculated using and reported as least squared mean differences (LSMDs) with 95% confidence intervals (CIs).ResultsThe study included 1291 NVAF patients with prior VKA treatment. The mean baseline ACTS burden and benefit scores were 50.51 ± 8.42 and 10.30 ± 2.70, respectively. After ∼ 3 months of rivaroxaban treatment, LSMDs were 4.38 points (95% CI: 2.53‐6.22, P < 0.0001) for the burden and 1.01 points (95% CI: 0.27‐1.75, P = 0.0075) for the benefit score. Fifty‐four percent and 48% of patients reported experiencing at least a minimally important clinical difference in burden and benefit scores, respectively.ConclusionsWithin this XANTUS cohort, switching from a VKA to rivaroxaban yielded statistically and clinically significant improvements in ACT burden and benefit scores.

show abstract

Patient-reported treatment satisfaction with oral rivaroxaban versus standard therapy in the treatment of pulmonary embolism; results from the EINSTEIN PE trial

Cited by 80 publications

References 30 publications

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients

Acute pulmonary embolism treatment with rivaroxaban results in a shorter duration of hospitalisation compared to standard therapy: an academic centre experience

Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS‐ACTS Substudy

Contact Info

Product

Resources

About