Efficacy and Safety of Rivaroxaban for the Prevention of Stroke in Subjects With Non-Valvular Atrial Fibrillation
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ClinicalTrials.gov Identifier: NCT00494871 |
Recruitment Status :
Completed
First Posted : July 2, 2007
Results First Posted : April 19, 2012
Last Update Posted : April 20, 2015
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Condition or disease | Intervention/treatment | Phase |
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Atrial Fibrillation | Drug: Rivaroxaban (Xarelto, BAY59-7939) Drug: Warfarin Drug: Rivaroxaban placebo Drug: Warfarin placebo | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 1280 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Triple (Participant, Care Provider, Investigator) |
Primary Purpose: | Prevention |
Official Title: | Evaluation of the Efficacy and Safety of Rivaroxaban (BAY59-7939) for the Prevention of Stroke and Non-central Nervous System Systemic Embolism in Subjects With Non-valvular Atrial Fibrillation |
Study Start Date : | June 2007 |
Actual Primary Completion Date : | December 2009 |
Actual Study Completion Date : | January 2010 |

Arm | Intervention/treatment |
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Experimental: Rivaroxaban (Xarelto, BAY59-7939)
Participants received once daily (OD) a rivaroxaban 15 mg tablet and a warfarin placebo tablet during the double-blind treatment period
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Drug: Rivaroxaban (Xarelto, BAY59-7939)
Participants orally administered rivaroxaban 15 mg OD (CrCL [creatinine clearance] >= 50 mL/min) or 10 mg OD (CrCL 30-49 mL/min) Drug: Warfarin placebo Participants orally administered a warfarin placebo tablet (adjusted based upon sham INR values) |
Active Comparator: Warfarin
Participants received OD a warfarin potassium tablet and a rivaroxaban placebo tablet during the double-blind treatment period
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Drug: Warfarin
Participants orally administered a warfarin potassium tablet (INR [international normalized ratio] target was 1.6-2.6 for patients >70 years and 2.0-3.0 for patients <70 years) Drug: Rivaroxaban placebo Participants orally administered a rivaroxaban placebo tablet |
- Event Rate of the Composite Endpoint of Adjudicated Major Bleeding or Adjudicated Non-major Clinically Relevant Bleeding [ Time Frame: Up to 2 days after the last dose ]Major bleeding: clinically overt bleeding (COB) associated with a fall in hemoglobin ≥2 g/dL, leading to transfusion ≥2 units of packed red blood cells or whole blood, occurring in a critical site or contributing to death. Non-major clinically relevant bleeding: COB that does not meet the definition of major bleeding, but requires medical intervention or unscheduled contact with the physician, (temporary) discontinuation of the study treatment, discomfort to the subject such as pain, or impairment of activities of daily life.
- Event Rate of the Composite Endpoint of Adjudicated Stroke and Non-central Nervous System (CNS) Systemic Embolism [ Time Frame: Up to 2 days after the last dose ]This is the principal efficacy endpoint. Stroke included hemorrhagic, ischemic infarction and unknown. Arterial emboli in the following areas were "non-CNS systemic embolism": peripheral arterial in the upper and lower extremities, renal, mesenteric, splenic, hepatic, ocular/retinal and others. Pulmonary embolism or myocardial infarction was excluded.
- Event Rate of the Composite Endpoint of Adjudicated Stroke, Non-CNS Systemic Embolism, and Vascular Death [ Time Frame: Up to 2 days after the last dose ]Stroke included hemorrhagic, ischemic infarction and unknown. Arterial emboli in the following areas were "non-CNS systemic embolism": peripheral arterial in the upper and lower extremities, renal, mesenteric, splenic, hepatic, ocular/retinal and others. Pulmonary embolism or myocardial infarction was excluded. Any death that was not clearly non-vascular.
- Event Rate of the Composite Endpoint of Adjudicated Stroke, Non-CNS Systemic Embolism, Myocardial Infarction, and Vascular Death [ Time Frame: Up to 2 days after the last dose ]Stroke included hemorrhagic, ischemic infarction and unknown. Arterial emboli in the following areas were "non-CNS systemic embolism": peripheral arterial in the upper and lower extremities, renal, mesenteric, splenic, hepatic, ocular/retinal and others. Pulmonary embolism or myocardial infarction was excluded. Myocardial infarction: assessed based on either cardiac biomarkers, new abnormal Q waves appeared on electrocardiogram for ≥2 leads, or autopsy confirmation. Any death that was not clearly non-vascular.
- Event Rate of Stroke [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. Stroke included hemorrhagic (Stroke with local collections of intraparenchymal blood. Subarachnoid hemorrhage, subdural hemorrhage, and epidural hemorrhage were excluded.), ischemic infarction (Stroke without focal collection of intracranial blood) and unknown (No imaging data and anatomic findings were available.).
- Event Rate of Non-CNS Systemic Embolism [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. Non-CNS systemic embolism was abrupt vascular insufficiency associated with clinical or radiological evidence of arterial occlusion in the absence of other likely mechanisms (such as trauma, atherosclerosis, and instrumentation). Arterial emboli in the following areas were "non-CNS systemic embolism": peripheral arterial in the upper and lower extremities, renal, mesenteric, splenic, hepatic, ocular/retinal and others. Pulmonary embolism or myocardial infarction was excluded from this category.
- Event Rate of Myocardial Infarction [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. Myocardial infarction was assessed based on either cardiac bio-markers (troponin I, troponin T, or creatine kinase-muscle and brain subunit isozyme), new abnormal Q waves appeared on ECG for 2 or more leads, or autopsy confirmation.
- Event Rate of Vascular Death [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. Any death that was not clearly non-vascular (e.g., deaths due to spontaneous bleeding, myocardial infarction, stroke, cardiac failure, and arrhythmia)
- Event Rate of Stroke With Serious Residual Disability [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. A stroke was considered disabling if the participant's modified Rankin score was between 3 and 5, inclusive.
- Event Rate of All-cause Death [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. All-cause death included vascular death and non-vascular death.
- Event Rate of Adjudicated Major Bleeding [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. Major bleeding was clinically overt bleeding associated with a fall in hemoglobin of 2 g/dL or higher, leading to a transfusion of 2 or more units of packed red blood cells or whole blood, occurring in a critical site or contributing to death.
- Event Rate Adjudicated Non-major Clinically Relevant Bleeding [ Time Frame: Up to 2 days after the last dose ]All events were adjudicated and confirmed by a central independent committee blinded to treatment. Non-major clinically relevant bleeding was clinically overt bleeding that does not meet the definition of major bleeding, but requires medical intervention or unscheduled contact with the physician, (temporary) discontinuation of the study treatment, discomfort to the subject such as pain, or impairment of activities of daily life.

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Ages Eligible for Study: | 20 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 20 years or older
- Japanese male or female
- Non- valvular atrial fibrillation documented by ECG
- Patients with a risk of stroke and non-CNS systemic embolism
Exclusion Criteria:
- Significant mitral stenosis
- Patients in whom anticoagulants are contraindicated

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00494871

Study Director: | Bayer Study Director | Bayer |
Responsible Party: | Bayer |
ClinicalTrials.gov Identifier: | NCT00494871 |
Other Study ID Numbers: |
12620 |
First Posted: | July 2, 2007 Key Record Dates |
Results First Posted: | April 19, 2012 |
Last Update Posted: | April 20, 2015 |
Last Verified: | April 2015 |
BAY59-7939 Rivaroxaban Non-Valvular Atrial Fibrillation |
Japanese Patients Phase III 12620 |
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes Warfarin Rivaroxaban |
Anticoagulants Factor Xa Inhibitors Antithrombins Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |