How do I know if I'm at risk for a DVT or PE event?
Deep vein thrombosis (DVT) and pulmonary embolism (PE) blood clot events can be unexpected and scary, and there are several risk factors known to increase the possibility of a DVT/PE event.
Finding resilience after recurring events
JOE
Age 68
Diagnosed with DVT/PE in 2012
Joe is a 68-year-old retiree who lives in Hawaii. He spends his time going to the beach, fishing, cycling, and gardening with his wife. By the looks of it, you would never know that Joe has suffered from recurring pulmonary embolisms (PE). His first one occurred in the middle of the night after a flight from Hawaii to Arizona. "I woke up and couldn't take a full breath, so I went to the emergency room," Joe said. There, the doctor asked Joe if he was having trouble with his left leg and if he had recently been on an airplane for an extended period. The answer to both was yes, and after "a battery of tests," Joe's doctors determined he had a PE. "I was surprised and very overwhelmed," Joe said. "There had been a knot in my left leg. I did the normal thing. Massage the muscle. Soak it in hot water. I did all those kind of things…and nothing seemed to work. [Had] I known about pulmonary embolisms, I probably would've got up and walked around, drank more water, all the things that I do now [while traveling]." Joe was prescribed warfarin to treat and help reduce the risk of another PE.
What is DVT/PE?
A PE occurs when a blood clot called a deep vein thrombosis (DVT) forms and travels to your lungs. DVT forms in a vein deep inside your body, such as in the legs. DVT is the third most common vascular diagnosis behind heart attack and stroke. It affects between 300,000 and 600,000 people in the US every year.
An estimated 60,000-100,000 Americans DIE OF DVT/PE every year.
Up to 12% of future DVT or PE blood clots RESULT IN A FATAL PE.
Risk Factors
Certain people are at higher risk for DVT/PE events: those who smoke, are over the age of 60, overweight, pregnant, or have a family history of blood clots. Slow blood flow due to immobility during extended travel, having a recent injury or surgery, and taking hormone medications are also risk factors. Joe met several of these criteria and experienced some telltale symptoms, which helped his doctors diagnose him. "Unexplained acute cough, especially if associated with blood, new and sudden shortness of breath, low oxygen levels, and, in extreme situations, cramping of the calf muscle, chest pain, passing out, or vision changes" are signs to watch out for, according to Dr. Kamran Boka, a pulmonary attending physician.
If you've already had a DVT or PE, YOUR RISK FOR ANOTHER INCREASES OVER TIME.
Unfortunately, Joe's first PE was not his last. "The disheartening thing is once you have one, you're more susceptible to have another one," Joe said. A year later, he was setting up chairs for an event when he started feeling the same sensation in his chest that he felt the night of his first PE. Immediately, Joe knew what was happening and went to the hospital, where he was diagnosed with another PE. There were no obvious causes for this event, so Joe continued taking warfarin, the medication initially prescribed for his condition, until he had yet another PE blood clot event the next year. That's when he and his doctors decided to revisit his treatment plan.
There are different types of blood thinners that treat DVT/PE. Anticoagulants help prevent or reduce blood clotting, and antiplatelet drugs help keep platelets (a type of blood cell) from sticking together and forming a clot.
“We want to reduce the stickiness of the blood and prevent existing clots from getting bigger. Anticoagulation blocks clotting and reduces that from happening."
Dr. Kamran Boka
Joe's doctors recommended he start taking XARELTO®, a blood thinner prescribed to treat and reduce the risk of DVT/PE blood clots from happening again. "I was happy to get it and happy to get on with my life," Joe said. "Getting back [to your life] after you've had a PE is the place every patient wants to be."
Deep vein thrombosis (DVT) and pulmonary embolism (PE) blood clot events can be unexpected and scary, and there are several risk factors known to increase the possibility of a DVT/PE event.
A common symptom is swelling in the affected limb, which is usually in the leg.
You might also feel cramping that turns into pain, skin that is warm to the touch, or see red or discolored skin.
Symptoms include sudden or unexplained shortness of breath, rapid breathing, chest pain under the rib cage that may worsen with deep breaths, feeling lightheaded, or coughing up blood.
PE is actually a complication of DVT and occurs when the DVT blood clot travels to the lungs. This blocks blood flow to the lungs, which can be life-threatening.
If you experience any symptoms of DVT or PE, seek medical attention immediately. This is because a DVT can become a PE, and PEs are often confused with other conditions like pneumonia.
It can be difficult for you to determine how serious the situation is. Blood clots can be life-threatening, so it's important to notify your doctor right away.
There are simple things you can do to reduce the risk of DVT/PE: avoiding sitting still for long periods, maintaining a healthy weight, staying active, and quitting smoking.
However, if you've already had an event, your risk of having another increases over time. In this case, taking blood thinners may help in prevention.
Blood thinners are used to treat DVT/PE blood clots by helping to prevent blood clots from growing larger and helping stop other clots from forming.
XARELTO® is a blood thinner proven to treat and reduce the risk of DVT/PE blood clots from happening again. In clinical studies, almost 98% of people taking XARELTO® did not experience another DVT or PE.*
XARELTO® has no known dietary restrictions and doesn't require regular blood monitoring.
*patients were followed for an average of 208 days.
After completing treatment for an initial DVT or PE, some people remain at risk for another event and may need to continue taking a blood thinner to help reduce their underlying risk. Some may take aspirin to help reduce their risk.
Aspirin may not be enough. XARELTO® is the only blood thinner that has been studied against aspirin and was proven to significantly reduce the risk of recurrent DVT/PE in people who have completed six months of treatment for an initial event.
In a clinical trial, people taking XARELTO® 10 mg were 3 times less likely to have another DVT or PE compared to people taking aspirin alone.
Be sure to do your research, maintain healthy habits, know the symptoms, keep in touch with your healthcare team and be sure to take your medication as prescribed.
Blood thinners are used to treat DVT/PE by PREVENTING CLOTS FROM GROWING AND NEW ONES FROM FORMING.
Blood thinners may continue to be taken to reduce the risk of future blood clots, even after completion of initial treatment. Work with your doctor to determine your need based on your risk factors.
After switching to XARELTO® from warfarin, Joe noticed some immediate advantages. "[Warfarin] was problematic [for me] because of the [dietary] restrictions … And that was something you really had to watch out for," Joe said. "[You also] had to have your blood [tested regularly]. That's something you don't have to do with XARELTO®."
People taking XARELTO® will take a higher dose during the first three weeks after a DVT or PE blood clot diagnosis, when the risk of having another one is the highest.
If you've had a DVT or PE, your risk of having another one increases over time, particularly once you complete treatment and no longer take a prescription blood thinner. In addition, future events can be more serious—even life-threatening. Up to 12% of future DVT or PE blood clots result in a fatal PE. XARELTO® was the only blood thinner studied vs aspirin that was proven to significantly reduce the risk of recurrent DVT/PE in people who had already completed six months of treatment for an initial event. In a clinical trial, people taking XARELTO® 10 mg were 3 times less likely to have another DVT or PE compared to people taking aspirin alone.
Maintaining a Positive Outlook
Beyond taking his medication, Joe takes steps to stay healthy by eating right and keeping his weight down. "I work out a lot. I cycle. I do as much hiking and walking as I can," Joe said. He also leans on his wife for additional support. "My wife has been very supportive. We support each other in our health. She's more athletic than me, so that keeps me pretty active—trying to keep up with her." And he is committed to doing what he needs to do to stay healthy. "I just take [my medicine], do what my doctors say, try to stay as healthy as I can and live my life and be happy."
If you have had a DVT or PE event, you know how scary it can be; however, it is manageable with treatment. That's why it's important to listen to your body like Joe did and know any symptoms that might indicate a blood clot. Remember, DVT/PE events are often unexpected, and your risk of having another increases over time. Talk to your doctor about treatment options and how to best help lower your risk.
In clinical trials, almost 98% of people taking XARELTO® DID NOT HAVE ANOTHER DVT OR PE.*
*Patients were followed for an average length of treatment of 208 days.
YOUR DOCTOR IS ALWAYS YOUR BEST RESOURCE. He or she knows your situation best and can help you determine a treatment plan.
WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT XARELTO®?
XARELTO® may cause serious side effects, including:
You may have a higher risk of bleeding if you take XARELTO® and take other medicines that increase your risk of bleeding, including:
Tell your doctor if you take any of these medicines. Ask your doctor or pharmacist if you are not sure if your medicine is one listed above.
Call your doctor or get medical help right away if you develop any of these signs or symptoms of bleeding:
If you take XARELTO® and receive spinal anesthesia or have a spinal puncture, your doctor should watch you closely for symptoms of spinal or epidural blood clots. Tell your doctor right away if you have back pain, tingling, numbness, muscle weakness (especially in your legs and feet), or loss of control of the bowels or bladder (incontinence).
XARELTO® is not for use in people with artificial heart valves.
XARELTO® is not for use in people with antiphospholipid syndrome (APS), especially with positive triple antibody testing.
Do not take XARELTO® if you:
Before taking XARELTO®, tell your doctor about all your medical conditions, including if you:
Tell all of your doctors and dentists that you are taking XARELTO®. They should talk to the doctor who prescribed XARELTO® for you before you have any surgery, medical or dental procedure.
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Some of your other medicines may affect the way XARELTO® works, causing side effects. Certain medicines may increase your risk of bleeding. See “What is the most important information I should know about XARELTO®?”
HOW SHOULD I TAKE XARELTO®?
If you take XARELTO® for:
© Janssen Pharmaceuticals, Inc. 2021May 2021cp-113688v4
WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT XARELTO®?
XARELTO® may cause serious side effects, including:
You may have a higher risk of bleeding if you take XARELTO® and take other medicines that increase your risk of bleeding, including:
Tell your doctor if you take any of these medicines. Ask your doctor or pharmacist if you are not sure if your medicine is one listed above.
Call your doctor or get medical help right away if you develop any of these signs or symptoms of bleeding:
If you take XARELTO® and receive spinal anesthesia or have a spinal puncture, your doctor should watch you closely for symptoms of spinal or epidural blood clots. Tell your doctor right away if you have back pain, tingling, numbness, muscle weakness (especially in your legs and feet), or loss of control of the bowels or bladder (incontinence).
XARELTO® is not for use in people with artificial heart valves.
XARELTO® is not for use in people with antiphospholipid syndrome (APS), especially with positive triple antibody testing.
Do not take XARELTO® if you:
Before taking XARELTO®, tell your doctor about all your medical conditions, including if you:
Tell all of your doctors and dentists that you are taking XARELTO®. They should talk to the doctor who prescribed XARELTO® for you before you have any surgery, medical or dental procedure.
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Some of your other medicines may affect the way XARELTO® works, causing side effects. Certain medicines may increase your risk of bleeding. See “What is the most important information I should know about XARELTO®?”
HOW SHOULD I TAKE XARELTO®?
If you take XARELTO® for:
