Ter Arkh. 2026 May 2;98(4):237-242. doi: 10.26442/00403660.2026.04.203513.
ABSTRACT
Atrial fibrillation is the most common type of arrhythmia, the "epidemic of the 21st century" and the leading cause of cardioembolic ischemic stroke. Clinical guidelines recommend direct oral anticoagulants as first-line therapy for the prevention of ischemic stroke in patients with atrial fibrillation. Rivaroxaban is a selective, direct factor Xa inhibitor widely used for the prevention of thromboembolic complications. However, optimal patient adherence to anticoagulant therapy is crucial for achieving treatment benefit. Key factors influencing compliance include the frequency of dosing and cost. Poor compliance increases the risk of stroke or transient ischaemic attack by 2-6 times. A meta-analysis of 39 studies (976 494 patients) confirmed higher adherence and persistence with the once-daily regimen compared to the twice-daily regimen (p<0.05). In December 2024, following the expiration of the patent for the original rivaroxaban, generic versions became available in Russia, including Rivaroxia® (KRKA, d.d., Novo Mesto). This high-quality generic, with proven bioequivalence and identical anticoagulant effect, offers an affordable alternative, reducing healthcare costs with a wide range of dosages.
PMID:42107127 | DOI:10.26442/00403660.2026.04.203513