Comparison of Rivaroxaban and Warfarin in the Prevention of Recurrent Venous Thromboembolism

The purpose of this systematic literature review is to determine the efficacy and safety of rivaroxaban (Xarelto) compared to warfarin (Coumadin), for the long term prophylaxis of recurrent venous thromboembolism (VTE). Rivaroxaban was chosen as the primary representative of factor Xa inhibitors because of its simplistic once a day dosing regimen. The PubMed database was extensively searched, using a variety of key terms, from September 10 to November 30, 2018. Works chosen include propensity-matched cohorts, retrospective studies, systematic reviews, and meta-analyses. All of which were published within the last 10 years; sources dated prior to 10 years were excluded. Studies with poor design or dual antiplatelet therapies were also grounds for exclusion. For this review, 11 resources were selected for analysis; 7 additional resources were included for contextual information. Much of the research revealed that rivaroxaban is an adequate alternative for VTE prophylaxis, but the purpose of this research was to determine if its efficacy and safety is superior to that of warfarin. Despite statistically superior results for several aspects of rivaroxaban, an absence of distinct recommendations remain. The following results are intended to make the difficult decision of choosing an anticoagulant clearer for medical professionals and patients