Xarelto Bleeding Risks

Since November of 2014, several lawyer-inspired Facebook threads have implicated rivaroxaban (Xarelto) in instance of “uncontrollable bleeding events and blood clots.” The October 9, 2014 issue of the ASH’s Blood journal presents a meta-analysis that reviewed twelve randomized controlled trials involving 102,607 patients taking TSOACs (target-specific oral anticoagulants, direct oral anticoagulants (DOACs). The authors conclude that when compared with warfarin (VKA), TSOACs are associated with less major bleeding, fatal bleeding, intracranial bleeding, clinically relevant nonmajor bleeding, and total bleeding. Additionally, TSOACs do not increase the risk of gastrointestinal bleeding. The article reference is  Chai-Adisaksopha C, Crowther M, Isayama T, Lim W. The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis. Blood. 2014;124:2450-8.