What about long-term anticoagulant treatment with rivaroxaban?  EINSTEIN Extension was a 600-patient study[11] that randomized patients to rivaroxaban 20 mg once a day or placebo.[10] The result, as expected, was a substantial reduction of about 70% to 80% in recurrent VTE, with an increase in major and clinically relevant non-major bleeding (Figure 22). 

In many respects the rivaroxaban program has confirmed and extended the attractive results of the dabigatran program – namely showing that the NOACs work at least as well as warfarin -- the treatment that has served for several decades as the standard of care.  The NOAC is associated with a reduction in bleeding, and during long-term treatment the NOAC is highly effective in preventing recurrence. The important benefit over warfarin is the ability to treat beginning immediately with rivaroxaban.  Eikelboom J. Am J Med 2013; published on-line at http://education.amjmed.com/00000.