A Phase 3 interventional study of Rivaroxaban (Xarelto, BAY59-7939) and Acetylsalicylic Acid (ASA) in Transcatheter Aortic Valve Replacement, sponsored by Bayer. Terminated at 140 sites in 17 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-01-13.
Sponsored by Bayer · Phase 3, Interventional, and Prevention
To assess whether a rivaroxaban-based anticoagulation strategy, following successful TAVR, compared to an antiplatelet-based strategy, is superior in reducing death or first thromboembolic events (DTE).
To assess the primary bleeding events (PBE) of the rivaroxaban-based strategy compared to an antiplatelet-based strategy, following TAVR.
Bayer is the lead sponsor of 1,643 studies on the registry; 57 are open to participants now.
Of its 209 completed or terminated interventional studies of FDA-regulated products, 129 (62%) have results posted.
Counted across the registry records on this site, refreshed daily.
Successful TAVR (Transcatheter Aortic Valve Replacement) of an aortic valve stenosis (either native or valve-in-valve)
Exclusion Criteria:
Subjects were treated with Rivaroxaban (10mg once-daily) and ASA (75-100mg once-daily) within first 90 days after randomization. After 90 days, ASA was discontinued and rivaroxaban (10mg once-daily) was to be continued alone. In the event of NOAF (New Onset of Atrial Fibrillation), subjects should be switched to rivaroxaban (20/15mg once-daily) and ASA (75-100mg once-daily) within first 90 days. After 90 days, ASA was discontinued and rivaroxaban (20/15mg once-daily) was to be continued alone.
Drug: Rivaroxaban (Xarelto, BAY59-7939) · Drug: Acetylsalicylic Acid (ASA)
Subjects were treated with clopidogrel (75mg once-daily) and ASA (75-100mg once-daily) within first 90 days after randomization. After 90 days, clopidogrel was discontinued and ASA (75-100mg once-daily) was to be continued alone. In the event of NOAF, subjects should start treatment of open-label VKA to target INR 2 to 3 (according to guidelines) and ASA (75-100mg once-daily) within first 90 days. After 90 days, ASA was discontinued and VKA was to be continued alone.
Drug: Acetylsalicylic Acid (ASA) · Drug: Clopidogrel · Drug: Vitamin K antagonist (VKA)
10mg OD (once-daily)
75-100mg OD
75mg OD
In case of NOAF, 20/15 mg OD (once-daily)
In case of NOAF, Open-label VKA therapy to target international normalized ratio (INR) 2-3, according to guidelines
Number of Participants With Death or First Thromboembolic Event (DTE)
Death or first adjudicated thromboembolic event (DTE), defined as composite of all-cause death, any stroke, myocardial infarction (MI), symptomatic valve thrombosis, pulmonary embolism (PE), deep vein thrombosis (DVT), and non-central nervous system (CNS) systemic embolism.
Time frame: Through study completion, on average 14 months
Number of Participants With Death or First Thromboembolic Event (DTE)
Death or first adjudicated thromboembolic event (DTE), defined as composite of all-cause death, any stroke, myocardial infarction (MI), symptomatic valve thrombosis, pulmonary embolism (PE), deep vein thrombosis (DVT), and non-central nervous system (CNS) systemic embolism.
Time frame: Through study completion, on average 16 months
Number of Participants With Primary Bleeding Event (PBE)
PBE is defined according to VARC (Valve Academic Research Consortium) definitions as the adjudicated composite of: Life-threatening, disabling or major bleeding.
Time frame: Through study completion, on average 16 months
Number of Participants With Net-clinical Benefit
The net-clinical-benefit defined as the adjudicated composite of all-cause death, any stroke, myocardial infarction, symptomatic valve thrombosis, pulmonary embolism, deep vein thrombosis, non-CNS systemic embolism (efficacy); VARC life-threatening, disabling and VARC major bleeds (safety).
Time frame: Through study completion, on average 16 months
Number of Participants With Cardiovascular Death or Thromboembolic Event
Composite of CV-death, any stroke, myocardial infarction (MI), symptomatic valve thrombosis, pulmonary embolism (PE), deep vein thrombosis (DVT), and non-central nervous system (CNS) systemic embolism (per adjudication).
Time frame: Through study completion, on average 16 months
Number of Participants With TIMI (Thrombolysis In Myocardial Infarction) Major / Minor Bleeds
Composite of TIMI major and minor bleedings
Time frame: Through study completion, on average 16 months
Number of Participants With ISTH (International Society on Thrombosis and Haemostasis) Major Bleeds
ISTH major bleeds
Time frame: Through study completion, on average 16 months
Number of Participants With Composite Bleeding Endpoint of BARC (Bleeding Academic Research Consortium) 2, 3, or 5 Bleeds
Composite of BARC 2,3 or 5 bleedings
Time frame: Through study completion, on average 16 months
Study was conducted at 136 centers world-wide between 16 Dec 2015 (first patient's first visit) and 27 Nov 2018 (last patient's last visit).
| Milestone | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Started | 826 | 818 |
| Received treatment | 801 | 807 |
| Completed | 799 | 792 |
| Not completed | 27 | 26 |
| Withdrew: Withdrawal by subject | 21 | 21 |
| Withdrew: Lost to follow-up | 5 | 5 |
| Withdrew: Adverse event | 1 | 0 |
Death or first adjudicated thromboembolic event (DTE), defined as composite of all-cause death, any stroke, myocardial infarction (MI), symptomatic valve thrombosis, pulmonary embolism (PE), deep vein thrombosis (DVT), and non-central nervous system (CNS) systemic embolism.
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With Death or First Thromboembolic Event (DTE) | 68 | 63 |
Death or first adjudicated thromboembolic event (DTE), defined as composite of all-cause death, any stroke, myocardial infarction (MI), symptomatic valve thrombosis, pulmonary embolism (PE), deep vein thrombosis (DVT), and non-central nervous system (CNS) systemic embolism.
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With Death or First Thromboembolic Event (DTE) | 105 | 78 |
PBE is defined according to VARC (Valve Academic Research Consortium) definitions as the adjudicated composite of: Life-threatening, disabling or major bleeding.
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With Primary Bleeding Event (PBE) | 46 | 31 |
The net-clinical-benefit defined as the adjudicated composite of all-cause death, any stroke, myocardial infarction, symptomatic valve thrombosis, pulmonary embolism, deep vein thrombosis, non-CNS systemic embolism (efficacy); VARC life-threatening, disabling and VARC major bleeds (safety).
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With Net-clinical Benefit | 137 | 100 |
Composite of CV-death, any stroke, myocardial infarction (MI), symptomatic valve thrombosis, pulmonary embolism (PE), deep vein thrombosis (DVT), and non-central nervous system (CNS) systemic embolism (per adjudication).
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With Cardiovascular Death or Thromboembolic Event | 83 | 68 |
Composite of TIMI major and minor bleedings
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With TIMI (Thrombolysis In Myocardial Infarction) Major / Minor Bleeds | 42 | 24 |
ISTH major bleeds
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With ISTH (International Society on Thrombosis and Haemostasis) Major Bleeds | 49 | 30 |
Composite of BARC 2,3 or 5 bleedings
| Participants | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet |
|---|---|---|
| Number of Participants With Composite Bleeding Endpoint of BARC (Bleeding Academic Research Consortium) 2, 3, or 5 Bleeds | 148 | 85 |
Collected over Through study completion, on average 14 months. Timeframe for All-Cause Mortality: After study medication start until last contact date.. Non-serious events are listed at a 0.2% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Rivaroxaban Arm | 70/801 (8.7%) | 296/801 (37%) | 359/801 (44.8%) |
| Antiplatelet Arm | 43/807 (5.3%) | 282/807 (34.9%) | 302/807 (37.4%) |
| Event | Rivaroxaban Arm | Antiplatelet Arm |
|---|---|---|
| Atrial fibrillationCardiac disorders | 17/801 | 25/807 |
| PneumoniaInfections and infestations | 23/801 | 22/807 |
| SyncopeNervous system disorders | 19/801 | 23/807 |
| Acute kidney injuryRenal and urinary disorders | 10/801 | 17/807 |
| Cardiac failureCardiac disorders | 16/801 | 16/807 |
| Atrioventricular block completeCardiac disorders | 12/801 | 15/807 |
| FallInjury, poisoning and procedural complications | 12/801 | 5/807 |
| OsteoarthritisMusculoskeletal and connective tissue disorders | 3/801 | 10/807 |
| DizzinessNervous system disorders | 9/801 | 4/807 |
| Cardiac failure congestiveCardiac disorders | 8/801 | 3/807 |
| Event | Rivaroxaban Arm | Antiplatelet Arm |
|---|---|---|
| Atrial fibrillationCardiac disorders | 43/801 | 44/807 |
| DizzinessNervous system disorders | 32/801 | 16/807 |
| Urinary tract infectionInfections and infestations | 30/801 | 19/807 |
| HypertensionVascular disorders | 26/801 | 28/807 |
| Oedema peripheralGeneral disorders | 16/801 | 20/807 |
| FallInjury, poisoning and procedural complications | 18/801 | 16/807 |
| VertigoEar and labyrinth disorders | 17/801 | 8/807 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 17/801 | 6/807 |
| SyncopeNervous system disorders | 10/801 | 15/807 |
| Cardiac failureCardiac disorders | 14/801 | 11/807 |
| Age, Continuous(Years) | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet | Total |
|---|---|---|---|
| Mean | 80.38 ± 7.12 | 80.77 ± 5.99 | 80.57 ± 6.58 |
| Sex: Female, Male(Participants) | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet | Total |
|---|---|---|---|
| Female | 400 | 413 | 813 |
| Male | 426 | 405 | 831 |
| Ethnicity (NIH/OMB)(Participants) | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet | Total |
|---|---|---|---|
| Hispanic or Latino | 26 | 17 | 43 |
| Not Hispanic or Latino | 677 | 694 | 1371 |
| Unknown or Not Reported | 123 | 107 | 230 |
| Race (NIH/OMB)(Participants) | Rivaroxaban (Xarelto, BAY59-7939) | Antiplatelet | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 2 | 1 | 3 |
| Native Hawaiian or Other Pacific Islander | 0 | 2 | 2 |
| Black or African American | 9 | 7 | 16 |
| White | 692 | 693 | 1385 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 123 | 115 | 238 |
Showing the first 100 of 140 sites across 17 countries.
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