Because DVT and PE are two parts of the same spectrum of disease, Figure 21 shows the pooled data from the results for EINSTEIN DVT and EINSTEIN PE.[12]  Many patients with DVT have subclinical PE and many patients with PE have DVT – and both sets of patients are treated in the same way, and the results are very clear and compelling: 

In this population of patients treated upfront (immediately) with rivaroxaban at a dose of 15 mg twice daily for 3 weeks followed by 20 mg once daily, continued out to 6 months, rivaroxaban was associated with a similar efficacy to control (ie, warfarin, preceded by LMWH).  Rivaroxaban did not reduce major or non-major clinically relevant bleeding (compared to control), but it substantially reduced the risk of major bleeding by almost 50%.  All-cause mortality was similar in the two groups: it was not significantly reduced, although if anything, the pattern was in favor of the new oral anticoagulant.  

Importantly these pooled results for the first 3 to 6 months of treatment were obtained by starting immediately with the NOAC rivaroxaban versus starting with injectable LMWH and then transitioning to oral warfarin.  Eikelboom J. Am J Med 2013; published on-line at http://education.amjmed.com/00000.