Key result
Low-dose apixaban (2.5 mg twice daily) showed no detected differences in recurrent VTE or major bleeding compared to full-dose apixaban (5 mg twice daily) during extended phase therapy.
Why the study?
The optimal dose of apixaban therapy to prevent a secondary venous thromboembolism event remains unconfirmed.
Does apixaban 2.5 mg twice daily prevent recurrent VTE and major bleeding as effectively as apixaban 5 mg twice daily in patients with VTE requiring extended phase anticoagulation?
Cohort
Yes
Does apixaban 2.5 mg twice daily prevent recurrent VTE and major bleeding as effectively as apixaban 5 mg twice daily in patients with VTE requiring extended phase anticoagulation?
Apixaban 2.5 mg twice daily is a viable alternative to 5 mg twice daily for extended phase risk reduction of VTE recurrence.
May support apixaban dose reduction for extended VTE prevention in select patients; leaves open need for randomized confirmation.
BACKGROUND: The optimal dose of apixaban therapy to prevent asecondary venous thromboembolism (VTE) event remains unconfirmed. To investigate the effects of extended phase use of apixaban (2.5 vs. 5 mg twice daily) beyond 6 months of initial treatment on the risk of recurrent VTE and major bleeding events among patients with a history of VTE. METHODS: A retrospective cohort analysis of two large national insurance claims databases was conducted for patients diagnosed with VTE. Cox proportional hazard models after propensity score matching were used to compare the risk of recurrent VTE and major bleeding. RESULTS: There were no detected differences in recurrent VTE or major bleeding events between patients prescribed low versus full dose apixaban. CONCLUSION: This study provides evidence that apixaban 2.5 mg twice daily is an alternative option for extended phase therapy for risk reduction of VTE recurrence compared to apixaban 5 mg twice daily.
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DeRemer et al. (2022) conducted a cohort in venous thromboembolism. Apixaban vs. Apixaban 5 mg twice daily was evaluated on recurrent VTE and major bleeding. Low-dose apixaban (2.5 mg twice daily) showed no detected differences in recurrent VTE or major bleeding compared to full-dose apixaban (5 mg twice daily) during extended phase therapy.
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