Low-Dose Rivaroxaban and Cardiovascular Events in Advanced Kidney Disease

Among patients with chronic kidney disease stage 4 or 5, including those receiving dialysis, does low-dose rivaroxaban (2.5 mg twice daily) reduce major adverse cardiovascular events compared with placebo?In this randomized, double-blind clinical trial of 1458 patients with chronic kidney disease stage 4 or 5, which was stopped early due to lack of efficacy, low-dose rivaroxaban did not reduce major adverse cardiovascular events (22.6% in the rivaroxaban group and 20.7% in the placebo group). Major bleeding rates occurred in 8.8% of patients in the rivaroxaban group and 6.0% of patients in the placebo group, a significant difference.In patients with advanced chronic kidney disease, compared with placebo, low-dose rivaroxaban did not reduce cardiovascular events, but increased rates of major bleeding.

Corresponding Author: Sunil V. Badve, PhD, Renal and Metabolic Division, The George Institute for Global Health, PO Box 6366, University of New South Wales Sydney, Sydney, NSW 1466, Australia (sbadve@georgeinstitute.org.au).

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