ACC: J&J, Bayer's blood thinner Xarelto scores in artery disease post-surgery

xarelto
Xarelto scored a FDA nod to reduce cardiovascular risks in peripheral artery disease patients in late October. (Johnson & Johnson)

Johnson & Johnson and Bayer's legacy blood thinner Xarelto has had a tough year with competitors picking up steam and prescriptions leveling off. But in a hard-to-treat artery disease, the drug just posted a new trial in recent post-surgery patients. 

A combination of Xarelto and aspirin reduced the risk of major limb and cardiovascular events by 15% over aspirin alone in symptomatic peripheral artery disease (PAD) patients who had recently undergone surgery to unblock arteries in their legs, according to data presented Saturday at the American College of Cardiology scientific sessions. 

At 28 weeks of treatment, 17.3% of patients treated with a Xarelto-aspirin combo suffered acute limb ischemia, major amputation for vascular cause, heart attack, ischemic stroke or cardiovascular death compared with 19.9% in the solo aspirin arm.

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The study also showed that while patients treated with Xarelto showed higher rates of bleeding, there wasn't a higher rate of severe bleeding events in the Xarelto arm, including intracranial or fatal bleeds. 

Around 10 million U.S. adults and 200 million patients worldwide suffer from PAD each year, according to a release. 

Xarelto, which received a FDA nod in October 2018 to reduce the risk of cardiovascular events in PAD patients, has faced an uphill climb against high-performing blood thinners like Pfizer and Bristol Myers Squibb's Eliquis, which has taken the market by storm in recent years after a slow initial launch. 

RELATED: J&J, Bayer's Xarelto scores FDA nod to treat acutely ill patients during and after hospitalization

In October, Xarelto scored an FDA nod––its eighth––to help prevent blood clots for acutely ill patients without a high risk of bleeding during and after hospitalization. The approval allowed patients who start the drug in the hospital to follow up at home for a recommended duration of 31 to 39 days, J&J said.

Of those eight approved indications, six specifically target blood clots, giving the partners hope that a broad range of eligible patients can help swing declining sales back around.

In 2019, Xarelto generated $2.3 billion in U.S. sales––a 6.6% decrease from the year before. In April, J&J attributed the drug's ongoing decline to stagnating prescription figures stateside, growing competition and the Medicare Part D "donut hole" provision.

Meanwhile, Eliquis has romped to the lead in the blood thinner market, topping the U.S. warfarin alternative field in terms of market share and then eventually overtaking warfarin itself. The partnered drug hit $6.2 billion in worldwide sales last year.

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