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Rivaroxaban, sold under the brand name Xarelto among others, is an anticoagulant medication (blood thinner) used to treat and prevent blood clots. [8] Specifically it is used to treat deep vein thrombosis and pulmonary emboli and prevent blood clots in atrial fibrillation and following hip or knee surgery. [ 8 ]
The monitoring of warfarin and keeping the international normalized ratio (INR) between 2.0 and 3.0, along with avoiding over and under treatment, has driven a search for an alternative. [3] [14] A naturally occurring inhibitor of factor Xa was reported in 1971 by Spellman et al. from the dog hookworm. [15]
Deep vein thrombosis may require thrombolysis if there is a significant risk of post-thrombotic syndrome. [42] Thrombolysis may be administered by intravenous catheter directly into the clot ("catheter-directed thrombolysis"); this requires a lower dose of the medication and may carry a lower bleeding risk but evidence for its benefit is limited.
Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. [9] [a] A minority of DVTs occur in the arms. [11] Symptoms can include pain, swelling, redness, and enlarged veins in the affected area, but some DVTs have no symptoms. [1]
The most widely documented treatment for livedoid vasculopathy is oral anticoagulation, which directly addresses dermal vessel thrombosis. [15] The most widely used of these is rivaroxaban , which showed a significant reduction in pain after 12 weeks of therapy in an uncontrolled phase 2a trial. [ 18 ]
Indication for Xa inhibitors is preventing deep vein thrombosis (DVT) which can lead to pulmonary embolism. It is also used to treat atrial fibrillation to lower the risk of stroke caused by a blood clot. Another indication is a prophylactic treatment for blood clotting due to atherosclerosis.
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