VOYAGER PAD with Manesh Patel, MD, and Schuyler Jones, MD


The Duke investigators return to discuss the pivotal study of rivaroxaban in peripheral artery disease.

Episode highlights

0:12 Intro
Lacking PAD focus
Manesh Patel, MD, and Schuyler Jones, MD


Published: May 21, 2020

Design: Double-blind, randomized trial

Population: 6564 patients with peripheral artery disease (PAD) who had undergone revascularization

Assessment: 2.5 mg twice-daily rivaroxaban plus aspirin, versus placebo plus aspirin, for the reduction of composite acute limb ischemia, vascular-related major amputation, myocardial infarction, ischemic stroke, or cardiovascular-related death

Safety outcome: Major bleeding per Thrombolysis in Myocardial Infarction (TIMI); major bleeding per International Society on Thrombosis and Haemostasis (ISTH)

Findings: Significantly lower composite outcome incidence with rivaroxaban plus aspirin versus placebo plus aspirin, with no significant difference in TIMI bleeding, and a greater incidence of ISTH bleeding in rivaroxaban patients

The impact: “There’s always got to be a therapy that’s the first therapy to show it’s reduced something, and it sets the bar for other studies. Once you have something that works, you can now demand other stuff has to work like it.”

Peripheral artery disease (PAD) research and innovations are generally not headline discussions at major cardiology meetings such as the American College of Cardiology (ACC) 2021 Scientific Sessions.

In fact, as some experts pointed out to HCPLive this year, the late-breaking agenda was sparse on topics regarding the common disease space. All the same, with distinctions of vascular disease beginning to more frequently deviate from the more popular methodologies and characteristics of progressive cardiology research, the same experts want to see more agents, more fruitful data, from the field of PAD.

VOYAGER PAD provides foundation by which more research can build upon.

In this third episode of HCPLive’s cardiology research podcast Heart Trials, in alignment with new late-breaking analyses presented at ACC 2021, VOYAGER PAD study author Manesh Patel, MD and his colleague, W. Schuyler Jones, MD, join to discuss the originally published research.

Patel is professor of Medicine and chief of the Division of Clinical Pharmacology and Division of Cardiology at the Duke University School of Medicine.

Jones is an associate professor of Medicine and Population Health Sciences at the Duke University School of Medicine.

Published in The New England Journal of Medicine in May 2020, VOYAGER PAD assessed selective direct factor Xa inhibitor rivaroxaban, plus aspirin, in patients with PAD who recently underwent revascularization.

Patel and colleagues sought an efficacy endpoint pertaining to composite major cardiovascular and vascular outcomes in treated patients, as well as major bleeding outcomes to interpret treatment safety.

Having been publicly shared and dissected for 1 year now this week, VOYAGER PAD could serve as a bar-setting clinical trial for the reduced risk of severe outcomes in patients with PAD, Patel said.

Listen to Heart Trials on your favorite podcast platforms, including Spotify and Apple Podcasts.

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