This week, we are very pleased to announce 🔈 the results from the TRACK trial « Low-Dose Rivaroxaban and Cardiovascular Events in Advanced Kidney Disease ».
🖲️ ❤️ 🫘 🏁 Cardiovascular events (sometimes fatal) affect 10% to 15% of patients with chronic kidney disease (CKD). Research into antithrombotic treatments for cardiovascular (CV) events in the context of CKD is ongoing.
🖲️ ❤️ 🫘 🏁This ambitious study, conducted from 2021 to 2025, aimed to determine whether low-dose Rivaroxaban (2.5 mg twice daily) reduces the rate of cardiovascular events compared to placebo.
🖲️ ❤️ 🫘 🏁Therefore, a randomized, double -blind, placebo-controlled trial was conducted across 12 countries (90 centers).
🖲️ ❤️ 🫘 🏁Eligibility criteria included stage 4 or 5 CKD or dialysis dependence, combined with a history of coronary artery disease, non-hemorrhagic/non lacunar stroke, peripheral artery disease, or diabetes, or an age of 65 years or older. The trial was terminated early in August 2025 due to a lack of efficacy.
🖲️ ❤️ 🫘 🏁The primary endpoint was a composite measure comprising cardiovascular death, non-fatal myocardial infarction, stroke, or a peripheral artery disease- related event.
🖲️ ❤️ 🫘 🏁In conclusion, low dose Rivaroxaban did not reduce high CV risk in patients with advanced CKD; major bleeding rates were significantly higher in the treated group.
🖲️ ❤️ 🫘 🏁These findings send a strong message regarding the risk-benefit balance of anticoagulant therapy (including at low doses) in frail patients such as those with CKD.
In France, INI-CRCT Coordinator Patrick Rossignol and INI-CRCT member Adrien Flahault conducted the study. Several other INI CRCT members including Laurent Billot, Jean-Michel Halimi, Vincent Esnault, and Ziad Massy were French PIs. Special thanks to all who took part including: Sunil Badve, Vlado Perkovic, Vivekanand Jha, Raja Ramachandran, Lily Mushahar, Jan Menne, An S De Vriese, Maha Al Ammari, Habib Skhiri, Michael Walsh, David Collister, Adrian Liew, Laurent Billot, Severine Bompoint, Anthony DEVAUX, Min Jun, Enmoore Lin, Aline Silvia Ramos da Cruz, Jeffrey Ha, John W Eikelboom, Ahmed Shaman, MClinPharm, DClinPharm, PhD, Meg Jardine, Shilpanjali Jesudason, Muh Geot Wong, Craig S Anderson, Amit X Garg, Hiddo J L Heerspink, Helen Monaghan, Anushka Patel, Patrick B Mark, David C Wheeler, Jicheng Lv, Li Zuo, Helen Pilmore, Martin Gallagher TRACK Low-Dose Rivaroxaban and Cardiovascular Events in Advanced Kidney Disease: The TRACK Randomized Clinical Trial. JAMA. 2026 Jun 4:e269379. doi: 10.1001/jama.2026.9379. Epub ahead of print. PMID: 42240165; PMCID: PMC13237706. https://lnkd.in/eVHXQpkb F-CRIN CHRU de Nancy Centre d’Investigation Clinique Plurithématique Edith DAUCHY Lila ZAKOUR Ons Bouzrara Taous ZAMOUM Nancy Hamilton Bénédicte rossignol Nicolas GIRERD Guillaume Baudry Marilucy Lopez Sublet Romain Boulestreau