Apixaban for the treatment and secondary prevention of thrombotic complications in cancer patients with impaired renal function

Malignant neoplasms are associated with a high risk of venous thromboembolic complications (VTEC), which worsen antitumor treatment and are the second leading cause of death after cancer progression. In patients with comorbid pathology, the risk of bleeding increases, especially during antithrombotic therapy. With a decrease in kidney function, the risk of bleeding increases 3-fold. To assess the possibilities of prescribing anticoagulant therapy to cancer patients with venous thrombosis and chronic kidney disease, a clinical observation is given.The article presents a case of a patient with breast cancer and chronic kidney disease. For the treatment and secondary prevention of deep vein thrombosis of the lower extremities, a patient received apixaban (Eliquis), which prevented the risk of recurrent venous thrombosis without increasing the risk of bleeding. Large randomized trials have shown the efficacy and safety of apixaban in the treatment and secondary prevention of VTEC in cancer patients, including patients with chronic kidney disease. According to the results of real clinical practice, apixaban was superior to standard therapy (low molecular weight heparin + vitamin K antagonists) in both efficacy and safety in the treatment and prevention of recurrent VTEC. Thus, the anticoagulant apixaban is one of the effective and safe factor Xa inhibitors, which is characterized by a rapid onset of action and predictable pharmacokinetics; it can be considered as an affordable and effective method for the treatment and prevention of recurrent VTEC, improving the quality of life and increasing the life expectancy of cancer patients.