When it comes to managing acute coronary syndrome, this trial has shown a "smallest-size-fits-all" result for Xarelto, Gibson said, with the 2.5 mg dosage performing better. "Less is more," he added.
However, other experts not connected to the study were a bit more cautious.
Before moving forward, Xarelto needs further study among people who are at high risk for bleeding, Drs. Matthew T. Roe and E. Magnus Ohman of Duke University Medical Center in Durham, N.C., wrote in an accompanying editorial in the journal.
They point out that better ways of predicting which patients are at risk for drug-related bleeds is also needed. Still, they wrote, "the results of this study indicate that rivaroxaban [Xarelto] will play an important role in the future of optimized secondary prevention."
For his part, American Heart Association President Dr. Gordon F. Tomaselli said that Xarelto and other, newer drugs may offer options to patients beyond warfarin. Other members of this relatively new class of drugs now include Pradaxa (dabigatran) and Brilinta (ticagrelor).
"Xarelto and the others are important new medications that are easier for patients to take and do not interact as much with other medications or foods," said Tomaselli, who is chief of cardiology at Johns Hopkins University School of Medicine in Baltimore. "They do cost more, but they don't require the monitoring infrastructure including frequent blood draws," he explained.
"For many people who hate taking warfarin, because it interferes with what they eat or take, these drugs are good alternatives," he said.
Other anti-clotting medications in development did not perform as well, according to two other studies also presented Sunday at the meeting, and also published in the New England Journal of Medicine.
One study, led by Dr. Pierlugi Tricoci of Duke University, looked at a blood thinner called vorapaxar. In a study invo
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