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Rivaroxaban

Phase 3

Pulmonary Embolism | Small molecule | Respiratory |Bayer AG|Last Updated: Sep 7, 2023

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLEDDMC
Total Trials1
Total Enrollment40

FDA Designations

No designations recorded

Clinical trial landscape

Rivaroxaban · 31 trials · 18 indications

Phase 3 15Phase 2 8Phase 1 8
NCT04662684Medically Ill Hospitalized Patients for COVID-19 THrombosis Extended ProphyLaxis With Rivaroxaban ThErapy: The MICHELLE TrialCovid19
COMPLETED320 Analytics
NCT02746185Cancer Associated Thrombosis, a Pilot Treatment Study Using RivaroxabanNeoplasm
COMPLETED159 Analytics
NCT02832544INVestIgation of rheumatiC AF Treatment Using Vitamin K Antagonists, Rivaroxaban or Aspirin Studies, Non-InferiorityRheumatic Heart Disease
COMPLETED4,565 Analytics
NCT02504216Efficacy and Safety of Rivaroxaban in Reducing the Risk of Major Thrombotic Vascular Events in Subjects With Symptomatic Peripheral Artery Disease Undergoing Peripheral Revascularization Procedures of the Lower ExtremitiesPeripheral Artery Disease
COMPLETED6,564 Analytics
NCT02234843EINSTEIN Junior: Oral Rivaroxaban in Children With Venous ThrombosisVenous Thromboembolism
COMPLETED500 Analytics
NCT01776424Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery DiseasePrevention & Control
COMPLETED27,395 Analytics
NCT01499953Superficial Vein Thrombosis (SVT) Treated With Rivaroxaban Versus FondaparinuxSuperficial Vein Thrombosis
COMPLETED472 Analytics
NCT01516840Venous Thromboembolism (VTE) Treatment Study in Japanese Deep Vein Thrombosis (DVT) PatientsDeep Vein Thrombosis
COMPLETED60 Analytics
NCT01516814Venous Thromboembolism (VTE) Treatment Study in Japanese Pulmonary Embolism (PE) PatientsPulmonary Embolism
COMPLETED40 Analytics
NCT01206972Dose-confirmatory Bridging Study in Total Knee ReplacementVenous Thromboembolism
COMPLETED302 Analytics
PHASE3COMPLETED
Medically Ill Hospitalized Patients for COVID-19 THrombosis Extended ProphyLaxis With Rivaroxaban ThErapy: The MICHELLE Trial
Covid19Unlock trial analytics
PHASE3COMPLETED
Cancer Associated Thrombosis, a Pilot Treatment Study Using Rivaroxaban
NeoplasmUnlock trial analytics
PHASE3COMPLETED
INVestIgation of rheumatiC AF Treatment Using Vitamin K Antagonists, Rivaroxaban or Aspirin Studies, Non-Inferiority
Rheumatic Heart DiseaseUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety of Rivaroxaban in Reducing the Risk of Major Thrombotic Vascular Events in Subjects With Symptomatic Peripheral Artery Disease Undergoing Peripheral Revascularization Procedures of the Lower Extremities
Peripheral Artery DiseaseUnlock trial analytics
PHASE3COMPLETED
EINSTEIN Junior: Oral Rivaroxaban in Children With Venous Thrombosis
Venous ThromboembolismUnlock trial analytics
PHASE3COMPLETED
Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease
Prevention & ControlUnlock trial analytics
PHASE3COMPLETED
Superficial Vein Thrombosis (SVT) Treated With Rivaroxaban Versus Fondaparinux
Superficial Vein ThrombosisUnlock trial analytics
PHASE3COMPLETED
Venous Thromboembolism (VTE) Treatment Study in Japanese Deep Vein Thrombosis (DVT) Patients
Deep Vein ThrombosisUnlock trial analytics
PHASE3COMPLETED
Venous Thromboembolism (VTE) Treatment Study in Japanese Pulmonary Embolism (PE) Patients
Pulmonary EmbolismUnlock trial analytics
PHASE3COMPLETED
Dose-confirmatory Bridging Study in Total Knee Replacement
Venous ThromboembolismUnlock trial analytics

Study Endpoints

Primary Endpoints

Venous thromboembolism and VTE related-death
at day 35 +/- post hospital discharge

a composite efficacy endpoint of symptomatic VTE, VTE-related death, and/or VTE detected by mandatory bilateral lower limbs venous duplex scan and computed tomography pulmonary angiogram on day 35+/-4 post-hospital discharge

Symptomatic DVT
3 months

Recurrent VTE during the 3-month treatment period including all symptomatic DVT (lower limbs distal and proximal DVTs, iliac and caval thrombosis, visceral thrombosis and deep vein thrombosis of the arm)

Symptomatic PE
3 months

Recurrent VTE during the 3-month treatment period including symptomatic PE

Unsuspected PE and DVT
3 months

Recurrent VTE during the 3-month treatment period including clinically unsuspected PE and DVT discovered incidentally

Worsening of pulmonary vascular or venous obstruction
3 months

Recurrent VTE during the 3-month treatment period including worsening of pulmonary vascular obstruction or venous obstruction on the systematic examinations performed at the end of the 3-month treatment period

Time from randomization to the first occurrence of vascular death or death of unknown cause, stroke, myocardial infarction or systemic embolism
Approximately 4 years

Vascular death or death of unknown cause, stroke, myocardial infarction or systemic embolism

Primary Efficacy Outcome: Number of Participants With Composite of Myocardial Infarction (MI), Ischemic Stroke, Cardiovascular Death, Acute Limb Ischemia (ALI) and Major Amputation Due to a Vascular Etiology
For each participant, the first occurrence of the composite primary efficacy outcome after randomization up until the efficacy cut-off date (08-Sep-2019) was considered. The mean time in follow-up survival time until ECOD that date was 1109.76 days.

Only the first occurrence of the outcome event under analysis within the data scope from a participant is considered.

Primary Safety Outcome: Number of Participants With TIMI (Thrombolysis in Myocardial Infarction) Major Bleeding
For each participant, the first occurrence of the primary safety outcome after randomization up until 2 days after permanent stop of study drug (rivaroxaban or rivaroxaban placebo).

Only the first occurrence of the outcome event under analysis within the data scope from a participant is considered.

Incidence Rates of All Symptomatic Recurrent Venous Thromboembolism During the Main Treatment Period
During the main study treatment period (i.e., 3 months, except for children with central venous catheter venous thromboembolism (CVC-VTE) aged <2 years for whom it was 1 month)

The Central independent adjudication committee (CIAC) classified symptomatic recurrent venous thromboembolism (VTE). Incidence = number of events / number at risk, where: number of events = number of subjects having the event in the time window. number at risk = number of subjects in reference population

Incidence Rates of All Symptomatic Recurrent Venous Thromboembolism During Extended Treatment Period
During extended treatment period: up to month 12.

Incidence rates for all children except those aged \< 2 years with catheter-related thrombosis. If no participant in the specific subgroup entered in the specific optional extension period, no analysis of an outcome was possible., The Central independent adjudication committee (CIAC) classified symptomatic recurrent venous thromboembolism (VTE). Incidence = number of events / number at risk, where: number of events = number of subjects having the event in the time window. number at risk = number of subjects in reference Population.

Number of Subjects With the Composite of All Symptomatic Recurrent Venous Thromboembolism During the 30 Days Post-study Treatment Period (i.e. >2 and ≤ 30 Days After Stop of Study Medication)
More than 2 and up to 30 days after stop of study medication

The Central independent adjudication committee (CIAC) classified symptomatic recurrent venous thromboembolism (VTE). Age group with primary efficacy outcome was reported.

Incidence Rates of the Composite of Treatment Emergent Overt Major Bleeding and Clinically Relevant Non-major (CRNM) Bleeding During Main Treatment Period
During the main study treatment period (i.e., 3 months, except for children with CVC-VTE aged <2 years for whom it was 1 month)

The Central independent adjudication committee (CIAC) classified bleeding as: Major bleeding defined as overt bleeding and: · associated with a fall in hemoglobin of 2 g/dL or more, or leading to a transfusion of the equivalent of 2 or more units of packed red blood cells or whole blood in adults, or occurring in a critical site, e.g. intracranial, intraspinal, intraocular, pericardial, intraarticular, intramuscular with compartment syndrome, retroperitoneal, or contributing to death. Clinically relevant non-major bleeding defined as overt bleeding not meeting the criteria for major bleeding, but associated with: medical intervention, or unscheduled contact (visit or telephone call) with a physician, or (temporary) cessation of study treatment, or discomfort for the child such as pain or impairment of activities of daily life (such as loss of school days or hospitalization).

Incidence Rates of the Composite of Treatment Emergent Overt Major Bleeding and Clinically Relevant Non-major (CRNM) Bleeding During Extended Treatment Period
During extended treatment period: up to month 12.

Incidence rates for all children except those aged \< 2 years with catheter-related thrombosis. If no participant entered in the specific optional extension period, no analysis of an outcome was possible. The CIAC classified bleeding as: Major bleeding defined as overt bleeding and: associated with a fall in hemoglobin of 2 g/dL or more, or leading to a transfusion of the equivalent of 2 or more units of packed red blood cells or whole blood in adults, or occurring in a critical site, e.g. intracranial, intraspinal, intraocular, pericardial, intraarticular, intramuscular with compartment syndrome, retroperitoneal, or contributing to death. Clinically relevant non-major bleeding defined as overt bleeding not meeting the criteria for major bleeding, but associated with: medical intervention, or unscheduled contact with a physician, or (temporary) cessation of study treatment, or discomfort for the child such as pain or impairment of activities of daily life.

The First Occurrence of the Composite Primary Efficacy Outcome, Myocardial Infarction (MI), Stroke, or Cardiovascular (CV) Death
For each participant, the first occurrence of the composite primary efficacy outcome after randomization up until the global rivaroxaban/aspirin outcomes cut-off date (06 FEB 2017) was considered. The mean time in follow-up until that date was 702 days.

Count of participants and time from randomization to the first occurrence of the composite primary efficacy outcome, MI, stroke, or CV death were evaluated. Hazard ratios were calculated and reported as statistical analysis.

The First Occurrence of the Primary Safety Outcome Major Bleeding Based on a Modification of the International Society on Thrombosis and Haemostasis (ISTH) Criteria
For each participant, the first occurrence of modified ISTH major bleeding after randomization up until the global rivaroxaban/aspirin outcomes cut-off date (06 FEB 2017) was considered. The mean time in follow-up until that date was 702 days.

Modified ISTH major bleeding is defined as: i) Fatal bleeding, or ii) Symptomatic bleeding in a critical area or organ, such as intraarticular, intracranial, intramuscular with compartment syndrome, intraocular, intraspinal, liver, pancreas, pericardial, respiratory, retroperitoneal, adrenal gland or kidney; or bleeding into the surgical site requiring reoperation, or iii) Bleeding leading to hospitalization (major bleeding also includes presentation to an acute care facility with discharge on the same day). Count of participants and time from randomization to the first occurrence of the primary safety outcome major bleeding were evaluated. Hazard ratios were calculated and reported as statistical analysis.

Rate of Objectively Confirmed VTE Complications
45 +/- 5 days

The primary efficacy outcome was the composite of death from any cause, symptomatic pulmonary embolism (confirmed by ventilation-perfusion scanning, helical computed tomography, pulmonary angiography, or autopsy), symptomatic deep vein thrombosis (confirmed by ultrasonography or venography), or symptomatic extension towards the saphenofemoral junction or symptomatic recurrence of superficial vein thrombosis (confirmed by ultrasonography) up to day 45.

Number of participants with newly onset of symptomatic venous thromboembolism (VTE)
Up to 12 months
Number of clinically relevant bleedings
Up to 2 days after last dose
A composite endpoint of any deep vein thrombosis (proximal and/or distal), non-fatal pulmonary embolism and death from all causes
up to Day 13 (±2 days)
Treatment-emergent bleeding (major, non-major clinically relevant, other non-major)
from the first intake of study medication to no later than 2 days after the last intake of study drug
Composite Endpoint of Total Venous Thrombo Embolism (VTE) i.e.: Any Deep Vein Thromboembolism (DVT) (Proximal and/or Distal), Non Fatal Pulmonary Embolism (PE), Death of All Causes Per Protocol Population
Up to 16 days after surgery

Blinded, adjudicated assessment of bilateral venography, clinical signs of deep vein thrombosis (DVT) and pulmonary embolism (PE), ultrasound, clinical chemistry and coagulation factors, autopsy report, electrocardiogram (ECG), pulmonary angiography, perfusion/ventilation lung scintigraphy, chest radiography, computed tomography

Composite Endpoint of Total VTE i.e.: Any DVT (Proximal and/or Distal), Non Fatal PE, Death of All Causes Per Modified Intent to Treat Population.
Up to 16 days after surgery

Blinded, adjudicated assessment of bilateral venography, clinical signs of deep vein thrombosis (DVT) and pulmonary embolism (PE), ultrasound, clinical chemistry and coagulation factors, autopsy report, electrocardiogram (ECG), pulmonary angiography, perfusion/ventilation lung scintigraphy, chest radiography, computed tomography

Composite endpoint of total VTE i.e.: Any DVT (proximal and/or distal), Non fatal PE, Death of all causes
Treatment period : up to day 36+/-6
Number of Subjects With Major Bleeding and Clinically Relevant Non-Major Bleeding Events
During or within 2 days after stop of study treatment (up to 32 days)

Major bleeding is defined as overt bleeding and: * associated with a fall in hemoglobin of 2 gram/decilitre (g/dL) or more, or * leading to a transfusion of the equivalent of 2 or more units of packed red blood cells or whole blood in adults, or * occurring in a critical site, for example (e.g.) intracranial, intraspinal, intraocular, pericardial, intraarticular, intramuscular with compartment syndrome, retroperitoneal, or * contributing to death. Clinically relevant non-major bleeding is defined as overt bleeding not meeting the criteria for major bleeding, but associated with: * medical intervention, or * unscheduled contact (visit or telephone call) with a physician, or * cessation (temporary) of study treatment, or * discomfort for the child such as pain or * impairment of activities of daily life (such as loss of school days or hospitalization).

Number of Subjects With Major and Clinically Relevant Non-Major Bleeding Events
From start of study drug administration until end of the 30-day treatment period

Central independent adjudication committee (CIAC) classified bleeding as follows: Major bleeding is defined as overt bleeding and: * associated with a fall in hemoglobin of 2 gram/decilitre (g/dL) or more, or * leading to a transfusion of the equivalent of 2 or more units of packed red blood cells or whole blood in adults, or * occurring in a critical site, e.g. intracranial, intraspinal, intraocular, pericardial, intra-articular, intramuscular with compartment syndrome, retroperitoneal, or * contributing to death. Clinically relevant non-major bleeding is defined as overt bleeding not meeting the criteria for major bleeding, but associated with: * medical intervention, or * unscheduled contact (visit or telephone call) with a physician, or * cessation (temporary) of study treatment, or * discomfort for the child such as pain or * impairment of activities of daily life (such as loss of school days or hospitalization).

The primary efficacy endpoint was the composite of symptomatic recurrent DVT or symptomatic fatal and non-fatal PE at 12 weeks and deterioration in thrombotic burden, as assessed by CUS and PLS, at baseline and at 12 weeks.
12 weeks
Composite Endpoint of Deep Vein Thrombosis (DVT), non-fatal Pulmonary Embolism (PE) and Death from all causes
6-10 days after surgery
Response to treatment as determined by a Complete Compression Ultra sound (CCUS)
21 days
Composite endpoints of Deep vein Thrombosis (proximal and/or distal),non fatal PE and death from all causes
5-9 days after surgery or earlier in case of symptoms indicating deep vein Thrombosis.
Composite Endpoint: Any Deep Vein Thrombosis (DVT) (proximal and/or distal) and Non fatal Pulmonary Embolism (PE) and Death from all causes
5-9 days after surgery
The primary efficacy endpoint is a composite endpoint of: - Any DVT (proximal and/or distal) and - Non fatal PE and - Death from all causes. The primary endpoint will be evaluated 5 - 9 days after surgery.
Assymptomatic DVT will be measured 5-9 days after surgery Symptomatc DVT , non-fatal PE and Death from all causes will be measured 41 days after surgery
Area under the concentration versus time curve from zero to infinity (AUC) of rivaroxaban in plasma after single dose
Pre-dose up to 72 hours post-dose
AUC from time zero to the last data point greater than (>) lower limit of quantification (LLOQ) (AUC[0-tlast]) of rivaroxaban in plasma after single dose
Pre-dose up to 72 hours post-dose

Area under the concentration versus time curve from zero to infinity (AUC)

Maximum observed drug concentration (Cmax) of rivaroxaban in plasma after single dose
Pre-dose up to 72 hours post-dose
AUC of rivaroxaban granules for oral suspension vs. rivaroxaban tablet
From pre-dose up to 72 hours after drug administration

AUC = area under the concentration vs. time curve from zero to infinity after single (first) dose Rivaroxaban Blood sampling for rivaroxaban pharmacokinetics in plasma.

AUC(0-tlast) of rivaroxaban granules for oral suspension vs. rivaroxaban tablet
From pre-dose up to 72 hours after drug administration

AUC(0-tlast) = AUC from time 0 to the last data point \> lower limit of quantification (LLOQ) Rivaroxaban Blood sampling for rivaroxaban pharmacokinetics in plasma.

Cmax of rivaroxaban granules for oral suspension vs. rivaroxaban tablet
From pre-dose up to 72 hours after drug administration.

Cmax = maximum observed drug concentration in measured matrix after single dose administration Rivaroxaban Blood sampling for rivaroxaban pharmacokinetics in plasma.

Concentration of Rivaroxaban in Plasma as a Measure of Pharmacokinetics at Day 1
30 minutes to 1.5 hours post-dose; 2 to 4 hours post-dose (bid dosing) and 30 minutes to 3 hours post-dose; 7 to 8 hours post-dose on Day 1 (tid dosing)

Concentration of pharmacokinetic parameters of rivaroxaban in plasma was evaluated.

Concentration of Rivaroxaban in Plasma as a Measure of Pharmacokinetics at Day 3
2 to 8 hours post-dose (bid dosing) and 30 minutes to 3 hours post-dose; 7 to 8 hours post-dose on Day 3 (tid dosing)

Concentration of pharmacokinetic parameters of rivaroxaban in plasma was evaluated.

Concentration of Rivaroxaban in Plasma as a Measure of Pharmacokinetics at Day 8
10 to 16 hours post-dose on Day 8 (bid dosing)

Concentration of pharmacokinetic parameters of rivaroxaban in plasma was evaluated.

Change From Baseline in Prothrombin Time at Day 1
10-16 hours post-dose on Day 8 (baseline), 2-4 hours after the first dose on Day 1 (bid dosing) and 7-8 hours after the first dose on Day 1 (tid dosing)

Prothrombin time is a global clotting test used for the assessment of the extrinsic pathway of the blood coagulation cascade.

Change From Baseline in Prothrombin Time at Day 3
10-16 hours post-dose on Day 8 (baseline), 2-8 hours post-dose on Day 3 (bid dosing) and 0.5-3 hours post-dose on Day 3 (tid dosing)

Prothrombin time is a global clotting test used for the assessment of the extrinsic pathway of the blood coagulation cascade.

Change From Baseline in Activated Partial Thromboplastin Time (aPTT) at Day 1
10-16 hours post-dose on Day 8 (baseline), 2-4 hours after the first dose on Day 1 (bid dosing) and 7-8 hours after the first dose on Day 1 (tid dosing)

The Activated partial thromboplastin time (aPTT) is a screening test for the intrinsic pathway and is sensitive for deficiencies of factors I, II, V, VIII, IX, X, XI and XII.

Change From Baseline in Activated Partial Thromboplastin Time (aPTT) at Day 3
10-16 hours post-dose on Day 8 (baseline), 2-8 hours post-dose on Day 3 (bid dosing) and 0.5-3 hours post-dose on Day 3 (tid dosing)

The Activated partial thromboplastin time (aPTT) is a screening test for the intrinsic pathway and is sensitive for deficiencies of factors I, II, V, VIII, IX, X, XI and XII.

Anti-factor Xa Activity (Anti-Xa) Values at Day 1
2-4 hours after the first dose on Day 1 (bid dosing) and 7-8 hours after the first dose on Day 1 (tid dosing)

The individual anti-Factor Xa activity was determined ex-vivo using a photometric method.

Anti-factor Xa Activity (Anti-Xa) Values at Day 3
2-8 hours post-dose on Day 3 (bid dosing) and 0.5-3 hours post-dose on Day 3 (tid dosing)

The individual anti-Factor Xa activity was determined ex-vivo using a photometric method.

Anti-factor Xa Activity (Anti-Xa) Values at Day 8
10-16 hours post-dose on Day 8 (both bid and tid dosing)

The individual anti-Factor Xa activity was determined ex-vivo using a photometric method.

Plasma concentration of rivaroxaban characterized by AUC
Dosing day(15 min, 30 min ,45 min ,1 ,1.5, 2, 2.5 ,3 , 4, 6,8,12,15 hours), at 48 hr after administration), at 72 hr after administration)

AUC:area under the concentration vs. time curve from zero to infinity after single (first) dose

Plasma concentration of rivaroxaban characterized by AUC/D
Dosing day(15 min, 30 min ,45 min ,1 ,1.5, 2, 2.5 ,3 , 4, 6,8,12,15 hours),at 48 hr after administration),at 72 hr after administration)

AUC/D: AUC divided by dose

Plasma concentration of rivaroxaban characterized by Cmax
Dosing day(15 min, 30 min ,45 min ,1 ,1.5, 2, 2.5 ,3 , 4, 6,8,12,15 hours),at 48 hr after administration),at 72 hr after administration)

Cmax: maximum drug concentration in plasma after single dose administration

Plasma concentration of rivaroxaban characterized by Cmax/D
Dosing day(15 min, 30 min ,45 min ,1 ,1.5, 2, 2.5 ,3 , 4, 6,8,12,15 hours),at 48 hr after administration),at 72 hr after administration)

Cmax/D: Cmax divided by dose

Cmax (maximum observed drug concentration in measured matrix after single dose administration)
Multiple time point up to 3 day
AUC(0-tlast) (AUC from time 0 to the last data point > LLOQ (lower limit of quantitation))
Multiple time point up to 3 day
Area Under the Concentration Versus Time Curve From Zero to Infinity After a Single Dose (AUC)
0-72 hours
Area Under the Concentration Versus Time Curve From Zero to Infinity Divided by Dose (AUC/D)
0-72 hours
Maximum Observed Drug Concentration in Measured Matrix After a Single Dose (Cmax)
0-72 hours
Maximum Observed Drug Concentration in Measured Matrix Divided by Dose (Cmax/D)
0-72 hours
Pharmacokinetics parameters (AUC and Cmax)
From Day 1 to Day 2
Pharmacodynamics parameters (PT, aPTT and anti-factor Xa)
From Day 1 to Day 2

Secondary Endpoints

Major bleeding
at day 35 +/- post hospital discharge
Major and clinically significant bleedings during the 3-month treatment period
3 months
Symptomatic recurrences of PE or DVT of the legs
3 months
Unlock Study Endpoints

Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposePREVENTION

Treatment Arms

ArmTypeDescription
RivaroxabanEXPERIMENTALRivaroxaban 10mg OD for 35+/- 4 days post-hospital discharge
No interventionNO_INTERVENTIONcontrol
Low-molecular-weight heparinACTIVE_COMPARATORdalteparin, 200 IU/kg subcutaneously once daily for one month followed by 150 IU/kg subcutaneously once daily for 2 months
Rivaroxaban (20 mg)EXPERIMENTALRivaroxaban 20 mg od (n \~ 2250); 15 mg od (once daily) in patients with creatinine clearance (CrCl) 15-49 ml/min
Vitamin K antagonists (VKA)ACTIVE_COMPARATORAny approved VKA in the participating country (n \~ 2250); VKA titrated to achieve an INR of 2.0-3.0
PlaceboPLACEBO_COMPARATORRivaroxaban-placebo orally twice daily
BAY59-7939EXPERIMENTALRivaroxaban (tablets and oral suspension) Dose: Age and body weight-adjusted dosing of rivaroxaban to achieve a similar exposure as that observed in adults treated for venous thromboembolism (VTE) with 20 mg rivaroxaban.
Standard of CareEXPERIMENTALSubcutaneous low molecular weight heparin (LMWH), subcutaneous fondaparinux and/or oral vitamin K antagonist (VKA) Dose : as per standard of care
Rivaroxaban 2.5mg + Aspirin 100mgEXPERIMENTALParticipants received rivaroxaban 2.5 mg twice daily (bid) and aspirin 100 mg once daily (od). All doses were provided in tablet form for oral administration. Participants who did not have a continuous need to take a proton pump inhibitor (PPI), were additionally randomized 1:1 to receive pantoprazole 40 mg (tablet form for oral administration, od) or matching placebo od. Participants who consented to LTOLE part received open label rivaroxaban 2.5 mg bid and aspirin 100 mg od in LTOLE part.
Rivaroxaban 5mg + Aspirin PlaceboEXPERIMENTALParticipants received rivaroxaban 5 mg bid and aspirin placebo od. All doses were provided in tablet form for oral administration. Participants who did not have a continuous need to take a PPI, were additionally randomized 1:1 to receive pantoprazole 40 mg (tablet form for oral administration, od) or matching placebo od. Participants who consented to LTOLE part received open label rivaroxaban 2.5 mg bid and aspirin 100 mg od in LTOLE part.
Rivaroxaban Placebo + Aspirin 100mgACTIVE_COMPARATORParticipants received rivaroxaban placebo bid and aspirin 100 mg od. All doses were provided in tablet form for oral administration. Participants who did not have a continuous need to take a PPI, were randomized 1:1 to receive pantoprazole 40 mg (tablet form for oral administration, od) or matching placebo od. Participants who consented to LTOLE part received open label rivaroxaban 2.5 mg bid and aspirin 100 mg od in LTOLE part.
FondaparinuxACTIVE_COMPARATORFondaparinux for 45 days subcutaneous application: 2,5 mg OD
Arm 1EXPERIMENTAL -
Arm 2EXPERIMENTAL -
Arm 3ACTIVE_COMPARATOR -
Arm 4ACTIVE_COMPARATOR -
Rivaroxaban 10 mg Once Daily (OD) ((Xarelto, BAY59-7939))EXPERIMENTALRivaroxaban (Xarelto, BAY59-7939) 10 mg tablet administered once daily (od) in the evening plus placebo syringes of enoxaparin twice a day (bid) administered once in the morning and once in the evening.
Enoxaparin 30 mg twice a day (bid)ACTIVE_COMPARATORPlacebo tablet of rivaroxaban administered once daily in the evening plus syringes of enoxaparin active substance 30 mg twice a day administered once in the morning and once in the evening.
Rivaroxaban (BAY59-7939) tablet, OD, Age: 12 - <18EXPERIMENTALSubjects aged from 12 - \<18 years were administered with age and body weight-adjusted oral dose of rivaroxaban (BAY59-7939) IR (immediate-release) tablet once daily (OD) under fed conditions for 30 days. Subjects with a body weight of 14 to less than 50 kilogram (kg) received a dose (equivalent to 20 milligram \[mg\] in adults) ranging from 5 to 15 mg, and subjects with a body weight (comparable to adults) of greater than or equal to 50 kg received a dose of 20 mg.
Comparator, Age: 12 - <18 yearsACTIVE_COMPARATORSubjects aged from 12 - \<18 years received comparator as per standard of care. The dosage given was to be adjusted based on the individual body weight (low molecular weight heparin, fondaparinux) or international normalized ratio (INR) adjusted (vitamin K antagonist).
Rivaroxaban (BAY59-7939) tablet, OD, Age: 6 - <12 yearsEXPERIMENTALSubjects aged from 6 - \<12 years were administered with age- and body weight-adjusted oral dose of rivaroxaban (BAY59-7939) IR tablet once daily under fed conditions for 30 days. Subjects with a body weight of 14 to less than 50 kg received a dose (equivalent to 20 mg in adults) ranging from 5 to 15 mg, and subjects with a body weight (comparable to adults) of greater than or equal to 50 kg received a dose of 20 mg.
Rivaroxaban (BAY59-7939) suspension, BID, Age: 6 - <12 yearsEXPERIMENTALSubjects aged from 6 - \<12 years were administered with age- and body weight-adjusted oral dose of rivaroxaban (BAY59-7939) suspension under fed conditions twice daily (BID). Subjects with a body weight of 9 to less than 50 kg received a total daily dose (equivalent to 20 mg in adults) ranging from 6.4 to 15 mg and subjects with a body weight of greater than or equal to 50 kg received a total daily dose of 20 mg.
Comparator, Age: 6 - <12 yearsACTIVE_COMPARATORSubjects aged from 6 - \<12 years received comparator as per standard of care. The dosage given was to be adjusted based on the individual body weight (low molecular weight heparin, fondaparinux) or INR-adjusted (vitamin K antagonist).
Arm 5EXPERIMENTAL -
Arm 6ACTIVE_COMPARATOR -
Treatment A-BEXPERIMENTALSubjects received a single oral dose of 10 mg rivaroxaban tablet in the fasted state on Day 1 (Treatment A) during intervention period 1; and then a single oral dose of 10 mg rivaroxaban oral suspension in the fasted state on Day 1 (Treatment B) during intervention period 2. A wash-out of at least 7 days was maintained between the treatments.
Treatment B-AEXPERIMENTALSubjects received a single oral dose of 10 mg rivaroxaban oral suspension in the fasted state on Day 1 (Treatment B) during intervention period 1; and then a single oral dose of 10 mg rivaroxaban tablet in the fasted state on Day 1 (Treatment A) during intervention period 2. A wash-out of at least 7 days was maintained between the treatments.
Treatment A: Single oral dose of a 20 mg tablet rivaroxabanEXPERIMENTAL2-way crossover: The subjects will receive the following treatments in a randomized order: * Treatment A: Single oral dose of a 20 mg tablet rivaroxaban, administered under fed conditions * Treatment B: Single oral dose of 20 mg rivaroxaban, granules for oral suspension administered under fed conditions.
Treatment B: Single oral dose of 20 mg rivaroxaban, granulesEXPERIMENTAL2-way crossover: The subjects will receive the following treatments in a randomized order: * Treatment A: Single oral dose of a 20 mg tablet rivaroxaban, administered under fed conditions * Treatment B: Single oral dose of 20 mg rivaroxaban, granules for oral suspension administered under fed conditions.
Arm 1 - BAY59-7939EXPERIMENTAL10 mg oral suspension (dry powder) in fasted conditions
Arn 2 - BAY59-7939EXPERIMENTAL20 mg oral suspension (dry powder) in fed conditions.
Arm 3 - BAY59-7939EXPERIMENTAL10 mg oral suspension in fasted conditions
Arm 4 - BAY59-7939EXPERIMENTAL10 mg tablet in fasted conditions.
BAY59-7939 granuleEXPERIMENTAL -
BAY59-7939 tabletACTIVE_COMPARATOR -
BAY59-7939 Rivaroxaban granuleEXPERIMENTAL -
BAY59-7939 Rivaroxaban tabletACTIVE_COMPARATOR -
Rivaroxaban (Treatment A) suspension (BN03501), fastedEXPERIMENTALSubjects received single oral dose of Rivaroxaban suspension 10 mg (Treatment A, Batch number BN03501) under fasting conditions in any intervention period.
Rivaroxaban (Treatment B) suspension (BN03501), fedEXPERIMENTALSubjects received single oral dose of Rivaroxaban suspension 20 mg (Treatment B, Batch number BN03501) under fed conditions in any intervention period.
Rivaroxaban (Treatment C) suspension (BR05701), fastedEXPERIMENTALSubjects received single oral dose of Rivaroxaban suspension 10 mg (Treatment C, Batch number BR05701) under fasting conditions in any intervention period.
Rivaroxaban (Treatment D) IR tablet, fastedEXPERIMENTALSubjects received single oral dose of Rivaroxaban IR tablet 10 mg (Treatment D) under fasting conditions in any intervention period.

Interventions

NameTypeDescription
Rivaroxaban 10 MGDRUGNo intervention
rivaroxabanDRUGrivaroxaban, 15 mg BD (Bis in die) for 3 weeks followed by 20mg OD (Omni die) for 9 weeks
Low-molecular-weight heparinDRUGdalteparin, 200 IU/kg OD for 4 weeks followed by 150 IU/kg OD for 8 weeks
Rivaroxaban (20 mg)DRUGRivaroxaban is non-inferior to VKAs for the prevention of stroke or systemic embolism in patients with AF/flutter and RVHD and potentially superior to VKAs.
Vitamin K antagonists (VKA)DRUG -
Rivaroxaban (Xarelto, BAY59-7939)DRUG2.5 mg, twice daily, orally, tablet
Rivaroxaban-PlaceboDRUGmatching placebo, twice daily, orally, tablet
Standard of CareDRUGLMWH (low molecular weight heparin) or fondaparinux or vitamin K antagonist (VKA) therapy. dose : as per standard of care
AspirinDRUGTablet, 100 mg, once daily, oral
Aspirin placeboDRUGAspirin matching placebo, once daily, oral
Rivaroxaban placeboDRUGRivaroxaban matching placebo, twice daily, oral
PantoprazoleDRUGTablet, 40 mg, once daily, oral, for participants who were not on a PPI and who were randomized to pantoprazole
Pantoprazole placeboDRUGPantoprazole matching placebo, once daily, oral, for participants who were not on a PPI and who were randomized to pantoprazole placebo
FondaparinuxDRUGFondaparinux Dose: 2.5 mg Duration: 45 (±5) days Frequency: once daily Application: subcutaneous
Unfractionated heparinDRUGTo be adjusted to maintain the activated partial thromboplastin time (aPTT) prolongation (1.5 to 2.5 times the control)
WarfarinDRUGTo be adjusted on the basis of prothrombin time-international normalized ratio (PT-INR) values target range (1.5 to 2.5)
Rivaroxaban (BAY59-7939)DRUGdaily dose: 5mg/day (5mg, once daily) for 11 to 12 days (±2 days)
EnoxaparinDRUGdaily dose: 40mg/day (20mg, twice daily) for 10 to 11 days (±2 days)
Placebo: tablet of RivaroxabanDRUGPlacebo tablet of rivaroxaban administered once daily in the evening.
Placebo: syringes of EnoxaparinDRUGPlacebo syringes of enoxaparin twice a day (bid) administered once in the morning and once in the evening.
Active comparatorDRUGSubjects received comparator as per standard of care. The dosage given was to be adjusted based on the individual body weight (low molecular weight heparin, fondaparinux) or international normalized ratio (INR) adjusted (vitamin K antagonist).
Rivaroxaban (BAY59-7939) suspensionDRUGSubjects aged were administered with age- and body weight-adjusted oral dose of rivaroxaban (BAY59-7939) suspension under fed conditions twice daily.
Xarelto (Rivaroxaban, BAY59-7939)DRUGBAY59-7939 20 mg once daily (od) for 12 weeks
(LMW) Heparin + Vitamin K AntagonistDRUGLow Molecular Weight (LMW) Heparin + Vitamin K Antagonist (VKA) for 5 days, then VKA only for the rest of 12 weeks
Enoxaparin/Vitamin K-AntagonistDRUGEnoxaparin/Vitamin K-Antagonist main treatment period of 21 days followed by an extended period of trial therapy until week 12 (Day 84). Enoxaparin was to be administered 1mg/kg bid sc for about 5-7 days. It was to be discontinued when INR was within the therapeutic range 2-3 for 2 consecutive days
Rivaroxaban, (BAY59-7939)DRUG5mg bid
EnoxaparineDRUG30mg bid
20 mg tablet rivaroxabanDRUGSingle oral dose of a 20 mg tablet rivaroxaban, administered under fed conditions
20 mg rivaroxaban, granules for oral suspensionDRUGSingle oral dose of 20 mg rivaroxaban, granules for oral suspension administered under fed conditions.
Rivaroxaban (BAY 59-7939)DRUGRivaroxaban granule 10mg for one day
Rivaroxaban (Xarelto, BAY 59-7939)DRUGRivaroxaban tablet 10mg for one day
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Eligibility Criteria

Age Range18 Years to 90 Years
SexALL
Healthy VolunteersNo
Study Sites1

Inclusion Criteria: * Male and nonpregnant female patients 18 years of age or older * Positive reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for SARS-CoV-2 in a respiratory tract sample * Pneumonia confirmed by chest imaging * Additional risk factors for VTE, as indicated by a tota...

Countries:BrazilFranceBotswanaCameroonChinaEgyptEthiopiaIndiaKazakhstanKenyaKyrgyzstanMalawiMexicoMozambiqueNepalNigeriaPakistanParaguayPhilippinesRwandaSouth AfricaSudanTanzaniaUgandaZambiaZimbabweUnited StatesArgentinaAustriaBelgiumBulgariaCanadaCzechiaDenmarkEstoniaFinlandGermanyHungaryItalyJapanLatviaLithuaniaNetherlandsPolandPortugalRomaniaRussiaSerbiaSlovakiaSouth KoreaSpainSwedenSwitzerlandTaiwanThailandUkraineUnited KingdomAustraliaHong KongIrelandIsraelSingaporeTurkey (Türkiye)ChileColombiaEcuadorMalaysiaNorwaySri LankaGreecePeruIndonesiaNew Zealand
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Competitive Landscape -Pulmonary Embolism 6 trials

Frequently asked questions about Rivaroxaban

What is Rivaroxaban used for?

Rivaroxaban is an investigational small molecule being studied for conditions including embolism, atrial fibrillation, venous thrombosis, superficial vein thrombosis, COVID-19, and neoplasms. It is also being evaluated for pharmacokinetics and biological availability. The drug is currently in Phase 1 clinical development.

What does Rivaroxaban target?

Rivaroxaban targets Factor Xa, a key enzyme in the coagulation cascade. By inhibiting Factor Xa, the drug aims to reduce blood clot formation. This mechanism is being studied across multiple indications, including venous thrombosis and atrial fibrillation, to assess its therapeutic potential.

Who makes Rivaroxaban?

Rivaroxaban is being developed by Bayer AG, a multinational pharmaceutical company. Bayer AG is publicly traded under the ticker symbol BAYRY on the OTC market. The company is conducting clinical trials to evaluate the drug's safety and efficacy in various patient populations.

What phase is Rivaroxaban in?

Rivaroxaban is currently in Phase 1 clinical development. While some completed trials include Phase 2 and Phase 3 studies, the most advanced ongoing development stage is Phase 1. The drug remains investigational and has not been approved for any indication.

What clinical trials is Rivaroxaban in?

Rivaroxaban has been studied in 10 clinical trials, all completed, with a total enrollment of 27,395 participants. Notable trials include NCT00839163, a Phase 2 study in deep vein thrombosis, and NCT02832544, a Phase 3 study in rheumatic heart disease. The trials are controlled but not double-blinded.

Is Rivaroxaban the same as Xarelto?

Rivaroxaban is the generic name for the drug also known as Xarelto. The trials listed in the data use the name Rivaroxaban, but Xarelto is the brand name under which the drug is commonly marketed. Both names refer to the same active pharmaceutical ingredient.