Xarelto Expanded Indication May Depend On Containing Worries About Bleeding

FDA advisory committee will review J&J/Bayer’s anticoagulant for a claim of reducing the risk of thrombotic cardiovascular events in patients with acute coronary syndrome. The product has a profoundly stronger database, but the same set of safety concerns, compared to when it was initially approved.

In considering a supplemental indication for Johnson & Johnson and Bayer AG’s anticoagulant Xarelto (rivaroxaban) on May 23, FDA’s Cardiovascular and Renal Drugs Advisory Committee might feel a bit of déjà vu, as bleeding events pose a safety concern just as they did when the panel took up the initial indication three years ago. But this time, the clinical database is more than twice as large and points to a statistically significant survival benefit.

The new application, for reducing the risk of thrombotic cardiovascular events in patients with ACS (ST or non-ST elevation myocardial...

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