The INVICTUS programme builds upon the REMEDY project[2], which released the findings of a pilot study in 2014.

heartdiagram3The pilot study researched 3,343 RHD patients from 14 countries in Africa, India and the Yemen and concluded that RHD, the most common acquired heart disease in children in many countries of the world, was being neglected and poorly treated.

The global burden of RHD, which is caused by rheumatic fever after an untreated strep throat infection, currently falls disproportionately on children and young adults living in the developing world, especially where poverty is widespread, such as Sub-Saharan Africa, India and other parts of Asia.

The programme was announced at the World Congress of Cardiology and Cardiovascular Health, taking place 4th – 7th June in Mexico. Researchers from the University of Cape Town and the Population Health Research Institute at McMaster University in Canada, along with the World Heart Federation are now calling on cardiovascular experts from around the world to join the project. The worldwide programme consists of a registry of 20,000 patients and two clinical trials that will examine if rivaroxaban can safely reduce strokes in patients with RHD.*

Professor Bongani M Mayosi, Professor of Medicine and head of the Department of Medicine at Groote Schuur Hospital and University of Cape Town, and one of the lead investigators for INVICTUS commented: “RHD with atrial fibrillation is a major cause of stroke, disability and death in children and young adults living in developing countries. Warfarin is the only effective preventive drug at the moment, but is notoriously difficult to use effectively and safely in many parts of world. INVICTUS will provide definitive information on the effectiveness and safety of the oral Factor Xa inhibitor Xarelto® (rivaroxaban) which is much easier to use than warfarin and less likely to cause fatal bleeding complications. [3]”

Professor Stuart Connolly from McMaster University in Canada, and the co-lead investigator commented: “The direct oral anticoagulants such as rivaroxaban have been shown in large clinical trials to be safe and effective in patients with non valvular atrial fibrillation in developed countries, but RHD patients were excluded from those trials.

“It is now time to show that RHD patients also can benefit from a drug like rivaroxaban in preventing strokes and other embolic events in patients with rheumatic valve disease.”

Professor Salim Yusuf, President of the World Heart Federation and Chairman of the Steering Committee of INVICTUS commented: “The launch of the RHD patient registry and trial programme on such a global scale forms a really key part of the international efforts underway to reduce RHD mortality rates and help meet the WHO 25×25 target. The registry of 20,000 patients from across all continents is ambitious but must be fulfilled if real progress is to be made and effective measures developed for those countries most affected to urgently put in place.”


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