July 15, 2013 — Janssen Research & Development LLC announced the U.S. Food and Drug Administration (FDA) has issued a complete response letter for the supplemental new drug application (sNDA) for Xarelto (rivaroxaban) to reduce the risk of stent thrombosis in patients with acute coronary syndrome (ACS).
"We remain confident in the results of the ATLAS ACS 2 TIMI 51 trial and are in ongoing discussions with the FDA regarding this sNDA," said Christopher Nessel, M.D., vice president, cardiovascular franchise medical leader at Janssen.
This sNDA is based on results from the 15,526-patient pivotal Phase 3 ATLAS ACS 2 TIMI 51 (Anti-Xa Therapy to Lower cardiovascular events in Addition to aspirin with/without thienopyridine therapy in Subjects with Acute Coronary Syndrome) clinical trial of Xarelto, which were presented at the American Heart Association (AHA) annual scientific sessions in November 2011 and simultaneously published by the New England Journal of Medicine. Data from the ATLAS ACS 2 TIMI 51 trial also support the separate sNDA for Xarelto to reduce the risk of cardiovascular events in patients with ACS, for which Janssen received a second complete response letter on March 4, 2013.
Coronary stents are implanted in more than 1.5 million patients each year. Stent thrombosis occurs in some partients as a complication from the body reacting to irritation inside the vessel from the implant, which can trigger the clotting cascade and form a blood clot. Stent thrombosis is an uncommon but serious complication that can result in a heart attack or even death.
Xarelto is currently approved for six clinical uses in the United States.
For more information: www.xareltohcp.com
November 14, 2025 
