Rob Dillard

DocwireNews

<p>In assessing hemorrhage risk factors for venous thromboembolism (<a href="https://www.docwirenews.com/docwire-pick/rheumatology-picks/risk-factors-for-vte-in-patients-with-psoriasis-psoriatic-arthritis/">VTE</a>) patients taking direct oral anticoagulants (DOACs), the use of <a href="https://www.docwirenews.com/conference-coverage/houston-acc-2021/apixaban-is-not-superior-to-standard-treatment-post-tavr/">apixaban</a> is correlated with reduced non-intracranial hemorrhage (ICH) and recurrent (rVTE) risk, compared to rivaroxaban, according to a study <a href="https://www.thrombosisresearch.com/article/S0049-3848(21)00375-3/fulltext">published in</a> <em>Thrombosis Research.</em></p>
<p>Traditionally, VTE has been treated orally using vitamin K antagonists, such as warfarin. More recently, DOACs have been administered instead due to convenience, lack of monitoring requirements, and mounting evidence of fewer bleeding events associated with DOACs compared to warfarin. Previous studies have showed that using DOACs, such as apixaban, is actually safer than warfarin with respect to the risk of brain hemorrhage in patients with DVT/PE without atrial fibrillation. Researchers of this study sought to comprehensively assess hemorrhage risk and rVTE in patients taking DOACs to treat VTE.</p>
<p>This study comprised 225,559 patients with VTE; of whom 34,201 received apixaban and 46,007 received rivaroxaban. Patients were identified using the Optum Clinformatics Data Mart (2003–2019). The study endpoints were defined as readmissions for intracranial hemorrhage (ICH), non-intracranial hemorrhage (non-ICH hemorrhage), and rVTE.</p>
<div class="section-paragraph">According to the results of the study, compared to rivaroxaban, apixaban was associated with both a decreased risk of non-ICH hemorrhage (sHR=0.560, 95% CI=0.423–0.741), but not ICH, and rVTE (sHR = 0.802, 95%CI = 0.651–0.988) risk. This was primarily in emergent readmissions (sHR[emergent hemorrhage] = 0.515, 95%, CI=0.372–0.711; sHR[emergent rVTE]=0.636, 95%, CI=0.488–0.830), the researchers noted.</div>
<div></div>
<div class="section-paragraph">The study identified several contributors to emergent hemorrhage in apixaban-treated patients; including older age (sHR = 1.025, 95%, CI = 1.011–1.039), female sex (sHR = 1.662, 95% CI, 1.252–2.207), prior prescription antiplatelet therapy (sHR=1.591, 95% CI, 1.130–2.241), and complicated hypertension (sHR=1.936, 95% CI, 1.134–3.307).</div>
<div></div>
<div>In terms of limitations, the research team noted the standard limitations associated with retrospective data-driven investigations; including potential selection bias, missing variables, and miscoded or missing data. Moreover, all diagnoses and prescriptions they analyzed were identified based on standardized coding systems, and clinical notes are not available to verify billed claims.</div>
<div></div>
<p>&#8220;Apixaban was associated with lower overall risk of hemorrhage and readmission for rVTE compared to rivaroxaban when treating patients with VTE without atrial fibrillation, even when excluding events taking place during a fixed three-week loading phase. These differences were derived after adjusting for outpatient mortality as a competing risk and translated into reductions in the number of emergency readmissions. Complicated hypertension and pulmonary disease, among other risk factors, were major contributors to hemorrhage risk on apixaban. In a risk-stratification exercise predicting hemorrhage risk at start of apixaban, we identified a subset of patients with a three-fold increase in bleeding risk who may benefit from closer monitoring and more frequent assessment of the risks and benefits of anticoagulation,&#8221; the researchers concluded.</p>
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">Hemorrhage risk of direct oral anticoagulants in real-world venous thr&#8230; <a href="https://t.co/uy8vE927Fz">https://t.co/uy8vE927Fz</a> <a href="https://t.co/KLB0VjnS6X">pic.twitter.com/KLB0VjnS6X</a></p>
<p>&mdash; Dr Jean Pierre Laroche #vacciné 6.0 (@Echoraljpangio) <a href="https://twitter.com/Echoraljpangio/status/1409423231212306435?ref_src=twsrc%5Etfw">June 28, 2021</a></p></blockquote>
<p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p>
<p>&nbsp;</p>
<p>&nbsp;</p>


Jordana Jampel

Gut Bacterial Translocation Prompts Epigenic Immune Response

Infectious Disease

First-Time Transient Ischemic Attack Associated With Long-Term Cognitive Decline

Stroke

Cecilia Brown

Phase 2 eNRGy Trial: Zenocutuzumab Shows Efficacy in NRG1 Fusion–Positive NSCLC

Non-Small Cell Lung Cancer

Latest News

Apixaban Reduces the Risk of Hemorrhage in VTE Patients

In assessing hemorrhage risk factors for venous thromboembolism (VTE) patients taking direct oral anticoagulants (DOACs), the use of apixaban is correlated with reduced ...

About Us

Editorial Policy

Advertising

eNewsletters

Contribute

Contact Us

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

Mesothelioma

Small Cell Lung Cancer

Squamous Cell Lung Carcinoma

Lung Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

The Oncology Brothers

Rheumatology Rounds With Dr. Maheswaranathan

Healthcare Unfiltered

The Fellow on Call

Partners

Hurricanes & Health Care

Career Center

Expert Interviews

Subscribe