Aliskiren (Rasilez®) is the first in a new drug class of oral direct renin inhibitors. Renin inhibition inhibits the conversion of angiotensinogen to angiotensin I. This is the rate-limiting step in the production of angiotensin II, which is a key mediator of blood pressure, body fluid volume, and vascular remodeling. It is administered at either 150 mg or 300 mg orally once daily.
Rivaroxaban is an already approved oral medicine used for the prevention of thrombotic vascular events in different types of artery diseases including PAD. It acts by blocking specific pathways involved in the process of blood clots within blood vessels, reducing the risk of a major vascular event. Aspirin alone is the current standard treatment in patients with PAD undergoing revascularization procedures but its risk reduction may not be adequate. If licensed rivaroxaban will potentially be an option as an add-on therapy in this patient group.