Can Xarelto's trial win in artery disease help J&J keep rival Eliquis at bay?

Johnson & Johnson and Bayer's Xarelto is under fire from Bristol-Myers Squibb and Pfizer's rival Eliquis.

Next-gen anticoagulant leader Xarelto from Johnson & Johnson and Bayer has fierce competition breathing down its neck. But now, the team has some positive trial results in hand that could help bolster the med's position.

On Wednesday, the companies announced that they’d stopped a trial early after Xarelto proved it could top aspirin at preventing major adverse cardiac events—including heart attack, stroke and CV death—in patients with coronary artery disease or peripheral artery disease. The study had been set to run through March of next year.

As J&J’s Janssen noted in a statement, CAD affects 16.5 million people in the U.S., while PAD plagues more than 10 million. And on a global basis, studies have suggested that about 20% of adults older than 55 show evidence of PAD.

That’s a sizable market that J&J and Bayer could have to themselves, at least where non-vitamin K antagonist oral anticoagulants (NOACs) are concerned. Xarelto is the only med in its class being studied in that patient population, the duo said in a statement. It also won’t be getting competition any time soon from AstraZeneca blood thinner Brilinta, which failed a PAD trial last October.

It’s not a bad time for Xarelto to snag a boost, what with Pfizer and Bristol-Myers Squibb’s Eliquis chasing it down for first place in the NOAC field. Third to the market behind Xarelto and Boehringer Ingelheim’s Pradaxa, Eliquis got off to a glacial start, but last month, Bristol-Myers CEO Giovanni Caforio told investors at the J.P. Morgan Healthcare Conference that “we think we are relatively close” to stealing the top spot in the total prescriptions ranking.