A poster on SI just asked why M118 is a better drug than Rivaroxaban. The answer is: it’s not better… it’s different.
M118 inhibits both FXa and FIIa (#msg-24393520), while Rivaroxaban inhibits FXa only. This makes Rivaroxaban unsuitable for use in such indications as ACS and stable angina where FIIa inhibition is obligatory.
On the other hand, for chronic prevention of DVT and chronic prevention of stoke in patients with AF, Rivaroxaban and other oral FXa inhibitors such as Apixaban enjoy the convenience of being a pill.
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