Fully Oral Therapy for Symptomatic Pulmonary Embolism

In a previous study, the oral factor Xa inhibitor rivaroxaban was as effective as standard enoxaparin-warfarin therapy for patients with proximal deep venous thrombosis (JW Gen Med Dec 21 2010). Now, industry-supported researchers have conducted a similar open-label, randomized trial involving nearly 5000 adults with acute symptomatic pulmonary embolism. Patients received either oral rivaroxaban (15 mg twice daily for 3 weeks, followed by 20 mg once daily) or standard therapy (subcutaneously injected enoxaparin followed by warfarin or acenocoumarol). Treatment duration was 3, 6, or 12 months, depending on the treating physician's preference. Exclusion criteria included creatinine clearance <30 mL/minute, clinically significant liver disease…