Bayer announced that Xarelto® (ingredient name: rivaroxaban) was presented at the American Congress of Cardiology’s 71st Annual Scientific Session (ACC 2022) in nonvalvular atrium with chronic kidney disease (CKD). We have published the results of the XARENO study confirming the clinical benefit of Xarelto® versus a vitamin K antagonist (VKA) in patients with Non-Valvular Atrial Fibrillation (NVAF).
XARELTO® is the first prospective observational study of XARENO®, the first prospective observational study, to compare patients with NVAF with advanced chronic kidney disease with patients with VKA or patients not taking oral anticoagulants (at the discretion of the attending physician) versus patients with NVAF with advanced chronic kidney disease. proceeded In the study, patients were treated with Xarelto® or VKA at the discretion of the attending physician, and patients not receiving anticoagulant treatment were also included in the study for exploratory analysis. Primary outcomes included chronic kidney disease progression and total clinical benefit (stroke and other thromboembolism, major hemorrhage, and death from any cause).
One-year follow-up of the XARENO study showed that Xarelto® had a greater total clinical benefit and a lower risk of renal failure compared to VKA in patients with NVAF with advanced chronic kidney disease.
Professor Reinhold Kreutz, Department of Clinical Pharmacy, Charité Medical University, Berlin, said, “Chronic kidney disease is a common condition, but it tends to be underestimated despite its serious impact on the patient’s quality of life, including death depending on the stage.” “The XARENO study will provide important evidence for medical staff treating patients with atrial fibrillation with chronic kidney disease, and will help reduce the patient’s risk of progression to renal failure.”
Chronic kidney disease is an independent risk factor for cardiovascular disease, and it is estimated that 15-20% of patients with atrial fibrillation also have chronic kidney disease. Because patients with atrial fibrillation with impaired renal function have a higher risk of stroke and bleeding, preventing renal function decline in the selection of oral anticoagulants for patients with atrial fibrillation is an important treatment goal that should be considered in addition to stroke prevention.
Following the ROCKET-AF, a randomized controlled trial (RCT) study, Xarelto® added evidence of prescribing to patients with renal impairment, including stage 4 chronic kidney disease patients. Through the XARENO study, XARELTO® has established a wider clinical basis compared to other NOACs (New Oral Anticoagulants) in preserving renal function.
The 2019 American Heart Association, Heart Association, and Arrhythmia Society (AHA, ACC, HRS) guidelines are different from other NOACs with a trough of the therapeutic range in patients with atrial fibrillation with renal impairment. It is recommended that it can be used in patients less than min.
“Previous studies evaluating stroke prevention in patients with atrial fibrillation excluded patients with advanced chronic kidney disease,” said Michael Devoy, head of Bayer Medical School. Because of this, we might not determine the clinical effect of NOAC versus VKA in this patient group.” “The XARENO study provides important clues to prevent disease progression and improve clinical prognosis in patients with atrial fibrillation with chronic kidney disease. did,” he said.
