Peripheral Artery Disease

August 27, 2021 – Results from a pre-specified subgroup analysis of the VOYAGER-PAD trial in patients with PAD and concomitant diabetes were presented at the 2021 European Society of Cardiology (ESC) meeting. The trial monitored the efficacy and safety of rivaroxaban in high-risk PAD patients after lower extremity revascularization (LER). The study result showed that patients with PAD and diabetes mellitus are at extremely high risk of adverse events of heart, limb, and brain after LER, and the efficacy of rivaroxaban 2.5 milligrams twice daily, in addition to low dose aspirin, with or without clopidogrel was similar in a patient with diabetes to the main trial population after LER for symptomatic PAD.

August 27, 2021 – The sex-based differences in the outcomes following peripheral artery revascularization in the VOYAGER-PAD trial were also discussed at the 2021 European Society of Cardiology (ESC) meeting. More than 1700 women had participated in the VOYAGER PAD study, and it was found that, compared to men, women are at higher risk for severe PAD and undergo lower extremity revascularization events. Furthermore, the efficacy and safety of rivaroxaban is similar in both men and women.

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August 27, 2021 – Results from a pre-specified sub-group analysis of the VOYAGER-PAD trial in fragile PAD patients after revascularization were presented at the 2021 European Society of Cardiology (ESC) meeting. The study found that rivaroxaban 2.5 milligram twice daily, in addition to low dose aspirin, with or without clopidogrel, is effective in reducing harmful events of limb, heart, and brain this subgroup of patients, an increase in bleeding (but not fatal bleeding) was also observed. As such, overall there was a net clinical benefit of administering rivaroxaban in these patients. Therefore, this agent can be considered in patients with symptomatic PAD and after LER regardless of age and fragility.

August 27, 2021 – The design and rationale of the STRIDE trial were also presented as a poster at the 2021 European Society of Cardiology (ESC) meeting.  This unique study is evaluating the effects of GLP-1RA semaglutide or other modern T2D drugs on clinical outcomes in patients with PAD and T2D.  The STRIDE study will monitor the impact of semaglutide on important outcomes in PAD patients that affect quality of life and everyday living.  Important outcomes will include walking ability, pain-free walking distance, as well as other PAD-specified and health-related patient-reported outcomes.  The ongoing study is the first and only dedicated PAD outcomes trial with a GLP-1 RA to date.

July 15, 2021 – In a new subgroup analysis of the COMPASS trial, the combination of low-dose rivaroxaban (2.5 mg twice/daily) and aspirin (100 mg once/daily) significantly reduced cardiovascular death compared to aspirin alone in patients with chronic CAD or PAD. Additionally, there were fewer deaths following MI, stroke, or cardiovascular procedures with the combination therapy, as well as fewer sudden cardiac, other, and unknown causes of CV deaths and coronary heart disease deaths. These mortality benefits were greater in patients with a higher baseline risk, supporting the results of the main study, which showed a greater benefit in patients with polyvascular disease, mild or moderate heart failure, chronic kidney disease, and diabetes. The results of this secondary analysis can better inform patient selection for dual pathway inhibition.

The full results of this study can be accessed here »