Most Read Articles
Rachel Soon, 16 Nov 2019

The third Pharmaceutical Industry Pharmacists Insight (PIPI 3.0) symposium will highlight areas of the pharmaceutical industry often overlooked by those entering the pharmacy profession.

Jairia Dela Cruz, 23 Apr 2019
Rupatadine at either 10 or 20 mg delivers superior improvements in nasal and ocular symptoms of seasonal allergic rhinitis compared with placebo, with both doses well tolerated by adult and adolescent patients, according to the results of a phase III trial.
02 Dec 2019
Podcast: Associate Prof Pilar Garrido says osimertinib may be the best option in the first-line treatment of advanced NSCLC based on FLAURA OS results.
Pearl Toh, 20 Dec 2019
Faecal microbiota transplantation (FMT) is effective in reducing symptoms of irritable bowel syndrome (IBS), but having a “super-donor” is key, a study presented at UEG* Week has shown — highlighting the importance of donor selection for the success of FMT as a treatment for IBS.

Rivaroxaban monotherapy safe, effective in AF, stable CAD patients

14 Nov 2019

In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.

AFIRE included 2,236 adult AF patients in Japan who had undergone percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG) >1 year earlier or who had angiographically confirmed CAD not requiring revascularization.

The patients were randomly assigned to receive rivaroxaban alone (n=1,118) or in combination with a single antiplatelet agent (n=1,118), but only 1,107 and 1,108 patients, respectively, were included in the modified intention-to-treat population (mean age, 74 years; 79 percent male).

Due to increased mortality in the combination group, the trial was terminated prematurely. This said, the effect of rivaroxaban monotherapy on the primary efficacy endpoint a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization or death from any cause proved noninferior to that of the combination (event rate, 4.14 percent vs 5.75 percent per patient-year; hazard ratio [HR], 0.72, 95 percent confidence interval [CI], 0.55–0.95; p-noninferiority<0.001).

In terms of safety, the monotherapy showed superiority, with the rate of major bleeding being 1.62 per patient year as opposed to 2.76 percent per patient-year with the combination (HR, 0.59, 95 percent CI, 0.39–0.89; p-superiority=0.01).

The findings must be interpreted in light of several limitations, according to researchers, pointing out that the early termination of the trial may overestimate the efficacy data. Thee researchers acknowledged that the benefit of rivaroxaban monotherapy on the rate of ischaemic events and death from any cause was unexpected and might be due to the play of chance.

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Most Read Articles
Rachel Soon, 16 Nov 2019

The third Pharmaceutical Industry Pharmacists Insight (PIPI 3.0) symposium will highlight areas of the pharmaceutical industry often overlooked by those entering the pharmacy profession.

Jairia Dela Cruz, 23 Apr 2019
Rupatadine at either 10 or 20 mg delivers superior improvements in nasal and ocular symptoms of seasonal allergic rhinitis compared with placebo, with both doses well tolerated by adult and adolescent patients, according to the results of a phase III trial.
02 Dec 2019
Podcast: Associate Prof Pilar Garrido says osimertinib may be the best option in the first-line treatment of advanced NSCLC based on FLAURA OS results.
Pearl Toh, 20 Dec 2019
Faecal microbiota transplantation (FMT) is effective in reducing symptoms of irritable bowel syndrome (IBS), but having a “super-donor” is key, a study presented at UEG* Week has shown — highlighting the importance of donor selection for the success of FMT as a treatment for IBS.