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Rivaroxaban for the treatment of deep vein thrombosis and ...

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Chi-square analyses were undertaken by <strong>the</strong> ERG which reported a p-value <strong>of</strong> 0.14, indicating no<br />

significant difference, but <strong>the</strong> number <strong>of</strong> events may be too small to highlight an actual difference.<br />

Whilst it is likely to be <strong>the</strong> case that <strong>the</strong> disparity in results were caused by chance alone, <strong>the</strong> clinical<br />

impacts <strong>of</strong> a PE are more serious than that <strong>of</strong> a DVT, <strong>and</strong> it was thought prudent to highlight <strong>the</strong><br />

potential impact <strong>of</strong> any assumption that <strong>the</strong> ratio <strong>of</strong> PE to DVT was independent <strong>of</strong> <strong>treatment</strong>. This is<br />

<strong>the</strong> subject <strong>of</strong> exploratory economic analysis later in <strong>the</strong> report.<br />

Figure 2: Kaplan-Meier plot <strong>for</strong> VTE recurrence (primary efficacy outcome) in<br />

EINSTEIN-DVT (reproduction <strong>of</strong> Figure 7, Page 55 <strong>of</strong> MS) 1<br />

Subgroup analyses <strong>for</strong> DVT recurrence – EINSTEIN-DVT<br />

A large number <strong>of</strong> subgroup analyses were presented in <strong>the</strong> report (Page 56, Figure 8, reproduced here<br />

as Figure 3). Interestingly, whilst <strong>the</strong> MS suggests <strong>the</strong>se were defined a priori, <strong>the</strong> ERG have not been<br />

able to locate a description <strong>of</strong> <strong>the</strong>se analyses in <strong>the</strong> protocol provided by <strong>the</strong> Manufacturer. 39 These<br />

may be contained in <strong>the</strong> Statistical Analysis Plans, which were not included with <strong>the</strong> protocol. As<br />

such, it is unclear whe<strong>the</strong>r <strong>the</strong> subgroup analyses were planned a priori.<br />

52<br />

Copyright 2012 Queen's Printer <strong>and</strong> Controller <strong>of</strong> HMSO. All rights reserved.

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