voyager 2.5 bid vascular dose presenation

Question 1

first slide script

Answer 1

“This first slide serves as a reminder to the pathogensis of thrombotic events”

A fibrin rich cap has a plaque rupture leading to a platelet plug with fibrin crosslinking which further narrows the lumen.

Question 2

Critical limb ischemia def

Second slide key point

Answer 2

is in the peripheral and is defined as a chronic blockage that puts the limb at risk for amputation and involves rest pain, minor or major wounds.

Critical limb ischemia often one will see an occlusion without signficant atheroscelerosis suggesting embolic disease as a source of the occlusion.

Question 3

Slide three segway for reach

What was Reach? How many patients? How many coutries

3 groups included’>

What were the atherothrombotic RF that were included?

Answer 3

Setting the stage for our discussion of the new dose of xarelto, we want to define the problem and determine who is at higher risk. The REACH registry is a unique way to accomplish this.

68,0000 patients in 44 countries

Paitents had to be in one of 3 groupings

1. CAD or PAD
2. Hx of cerebrovacular disease
3. >= to 3 atherothrombotic risk factors.

Question 4

1. What is the THM of the reach registry? (2)
2. How were CV events defined

Answer 4

1. event rates over 4 years with CAD and PAD in these cohorts were very very hight 17.6% or CAD 15% at 4 years. CV event was defined as CV death, MI or stroke.
2. patients with polyvascular disease did much worse the single vessel disease

Question 5

1.Slide 7 with 17.4% composite 7.4% ALI and 6.9% maj amp.

Answer 5

1. 40K patients with PAD had a periperhal revasc from there nearly 1 in 5 had an major adverse vasular event event , mean follow up only 1.4 years
   - insuracne claims data
2. concerningly 7.4% developed ALO and 6.9% had a major amp.

Question 6

WP of patients had poly vascular dz in rEACH

Answer 6

1 in 5

patients with polyvascualr disease had extremly high risk of repeat event or death

Question 7

Side from JAnses tieh the three boxes

How many RCTS JAnnsen run with Xarelto?

Answer 7

remind you that largest clinical trial program within DOACs. with over 20 RCTS

More dosing regimines than any other offering proven efficicay and saftey with the most indications.

20 RCTS the trials listed on the left side with indication on the right. Today we are going to focus on Compass and Esp Voyager PAD.