Abstract
Peripheral artery disease (PAD) is the third most common manifestation of atherosclerosis after coronary artery (CAD) and cerebrovascular disease (CVD). People with PAD have plaque findings in other vascular territories as well and, thus, are at increased risk of major adverse cardiovascular or cerebrovascular events (MACCE), including myocardial infarction, and stroke. In that context, the COMPASS multicenter, randomized controlled trial showed that the risk of MACCE was significantly reduced by 24% in the rivaroxaban plus aspirin arm compared with aspirin alone (4.1% vs 5.4% respectively; HR: 0.76, 95% CI: 0.66 to 0.86). Interestingly, the rivaroxaban/aspirin arm also showed a reduction in cardiovascular death (HR: 0.78; 95% CI: 0.64-0.96]) and allcause mortality (HR: 0.82; 95% CI: 0.71-0.96) by 22% and 18%, respectively. Recently, the FDA approved the use of the dual pathway approach, rivaroxaban 2.5 mg twice daily plus aspirin 75-100mg once daily, to reduce the risk of major cardiovascular (CV) events, such as CV death, myocardial infarction and stroke, in people with CAD as well as PAD. In comparing rivaroxaban plus aspirin versus aspirin alone, a preliminary economic analysis showed that saving per patient was USD 462 for events and USD 220 for procedures with a total reduction of USD 682 per participant in the US with the combination group (rivaroxaban plus aspirin). The data from COMPASS trial suggest that low dose rivaroxaban plus aspirin may be a preferred treatment strategy in PAD patients in whom the bleeding risk is deemed to be favourable.
Keywords: Rivaroxaban, clopidogrel, peripheral artery disease, COMPASS trial, atherosclerosis, cerebrovascular disease.
Current Pharmaceutical Design
Title:Rivaroxaban versus Clopidogrel for Peripheral Artery Disease: A Clinico-Economic Approach of the COMPASS Trial
Volume: 24 Issue: 38
Author(s): Diamantis I. Tsilimigras, Demetrios Moris*, Georgios Karaolanis, Stavros K. Kakkos, Konstantinos Filis and Fragiska Sigala
Affiliation:
- Department of Surgery, Duke University Medical Center, Duke University, Durham, NC,United States
Keywords: Rivaroxaban, clopidogrel, peripheral artery disease, COMPASS trial, atherosclerosis, cerebrovascular disease.
Abstract: Peripheral artery disease (PAD) is the third most common manifestation of atherosclerosis after coronary artery (CAD) and cerebrovascular disease (CVD). People with PAD have plaque findings in other vascular territories as well and, thus, are at increased risk of major adverse cardiovascular or cerebrovascular events (MACCE), including myocardial infarction, and stroke. In that context, the COMPASS multicenter, randomized controlled trial showed that the risk of MACCE was significantly reduced by 24% in the rivaroxaban plus aspirin arm compared with aspirin alone (4.1% vs 5.4% respectively; HR: 0.76, 95% CI: 0.66 to 0.86). Interestingly, the rivaroxaban/aspirin arm also showed a reduction in cardiovascular death (HR: 0.78; 95% CI: 0.64-0.96]) and allcause mortality (HR: 0.82; 95% CI: 0.71-0.96) by 22% and 18%, respectively. Recently, the FDA approved the use of the dual pathway approach, rivaroxaban 2.5 mg twice daily plus aspirin 75-100mg once daily, to reduce the risk of major cardiovascular (CV) events, such as CV death, myocardial infarction and stroke, in people with CAD as well as PAD. In comparing rivaroxaban plus aspirin versus aspirin alone, a preliminary economic analysis showed that saving per patient was USD 462 for events and USD 220 for procedures with a total reduction of USD 682 per participant in the US with the combination group (rivaroxaban plus aspirin). The data from COMPASS trial suggest that low dose rivaroxaban plus aspirin may be a preferred treatment strategy in PAD patients in whom the bleeding risk is deemed to be favourable.
Export Options
About this article
Cite this article as:
Tsilimigras I. Diamantis , Moris Demetrios *, Karaolanis Georgios , Kakkos K. Stavros , Filis Konstantinos and Sigala Fragiska , Rivaroxaban versus Clopidogrel for Peripheral Artery Disease: A Clinico-Economic Approach of the COMPASS Trial, Current Pharmaceutical Design 2018; 24 (38) . https://dx.doi.org/10.2174/1381612825666190101100832
DOI https://dx.doi.org/10.2174/1381612825666190101100832 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Which are the Best Follow-Up Strategies for Patients Who Undergo Percutaneous Coronary Interventions?
Current Cardiology Reviews Exploring the Potential of NO-Independent Stimulators and Activators of Soluble Guanylate Cyclase for the Medical Treatment of Erectile Dysfunction
Current Pharmaceutical Design Subject index to volume 3
Current Molecular Medicine Thyroid Hormone-Induced Angiogenesis
Current Cardiology Reviews Testosterone Deficiency in Male: A Risk Factor for Heart Failure
Endocrine, Metabolic & Immune Disorders - Drug Targets Safety Profile of Plasmid/Liposomes and Virus Vectors in Clinical Gene Therapy
Current Drug Safety New Perspectives on Acetaminophen
Current Cardiology Reviews Study on the Effects of Kuanxiong Aerosol on the Isolated Artery and Rabbits Acute Myocardial Ischemia Model
Combinatorial Chemistry & High Throughput Screening Strategies for Leukotriene Modulation in Dermatology: Even More Visionary Perspectives? An Update
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Morphofunctional Aspects of the Blood-Brain Barrier
Current Drug Metabolism Protease-Activated Receptors (PARs) are Partly Pro-Inflammatory and Partly Anti-Inflammatory: Will PAR Agonists or Antagonists Participate in Future Drug Therapies?
Current Drug Targets Application of Stem Cells in Cardiology: Where we are and where we are Going
Current Stem Cell Research & Therapy Extracellular Vesicles as Drug Delivery Vehicles for Rheumatoid Arthritis
Current Stem Cell Research & Therapy Cellular and Pharmacological Targets to Induce Coronary Arteriogenesis
Current Cardiology Reviews Modulating the Hypoxia-Inducible Factor Signaling Pathway: Applications From Cardiovascular Disease to Cancer
Current Pharmaceutical Design Aesthetic Cardiology: Adipose-Derived Stem Cells for Myocardial Repair
Current Stem Cell Research & Therapy Neutrophil Gelatinase-associated Lipocalin as a Marker of Postoperative Acute Kidney Injury Following Cardiac Surgery in Patients with Preoperative Kidney Impairment
Cardiovascular & Hematological Disorders-Drug Targets Modulatory Role of Nitric Oxide/cGMP System in Endothelin-1-Induced Signaling Responses in Vascular Smooth Muscle Cells
Current Cardiology Reviews On the Structural Basis of the Hypertensive Properties of Angiotensin II: A Solved Mystery or a Controversial Issue?
Current Topics in Medicinal Chemistry Lectin-Like Oxidized Low Density Lipoprotein Receptor 1 (LOX-1) in Atherogenesis: A Brief Review
Current Medicinal Chemistry