Effectiveness and Safety of Apixaban versus Warfarin in Venous Thromboembolism Patients with Chronic Kidney Disease

Figures

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  Fig. 1. Patient selection criteria. The figure illustrates the process and selection criteria used to identify patient records from the databases used in this study. Patient records were included if the patient had both CKD (defined by ICD-9-CM codes 585.1–585.9 or ICD-10-CM codes N18.1–N18.9) and a diagnosis of VTE, and was treated with either apixaban or warfarin within 30 days after the index VTE. Patients were excluded on the basis of the following criteria: age (Medicare only), health insurance continuous enrollment status, medical history, and medication use. CKD, chronic kidney disease; CM, clinical modification; ICD, International Classification of Diseases; OAC, oral anticoagulant; PAC, parenteral anticoagulant; VTE, venous thromboembolism. a MarketScan: September 2018; Optum and Humana: December 2018; PharMetrics: March 2019; CMS Medicare: December 2016.

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  Fig. 2. Risk of recurrent venous thromboembolism (VTE), major bleeding, and clinically relevant nonmajor bleeding among patients with chronic kidney disease prescribed apixaban or warfarin to treat VTE. The figure shows a forest plot of the risks of recurrent VTE, major bleeding, and CRNMB. The patient population consisted of patients with CKD being treated for VTE with apixaban or warfarin during the study period. The number of events and the incidence per 100 person-years are listed for each outcome and treatment. Risk is indicated by an HR and 95% CI. The degree of risk is indicated along the x -axis. Black squares indicate the hazard ratio; solid black lines indicate the 95% CI. CI, confidence interval; CKD, chronic kidney disease; CRNMB, clinically relevant nonmajor bleeding; HR, hazard ratio; VTE, venous thromboembolism.

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  Fig. 3. Risk of recurrent venous thromboembolism (VTE), major bleeding, and clinically relevant nonmajor bleeding among patients with chronic kidney disease prescribed apixaban or warfarin to treat VTE, stratified by CKD stages. The figure shows a forest plot of the risks of recurrent VTE, major bleeding, and CRNMB. The patient population consisted of patients with CKD being treated for VTE with apixaban or warfarin during the study period, stratified by the stage of CKD (stage I/II, stage III, stage IV, stage V/ESRD). The number of events and the incidence per 100 person-years are listed for each outcome, stage, and treatment. Risk is indicated by an HR and 95% CI. The degree of risk is indicated along the x -axis. The p -value for interaction indicates the association between CKD stages and treatment effects on a specific outcome. Black squares indicate the hazard ratio; solid black lines indicate the 95% CI. CI, confidence interval; CKD, chronic kidney disease; CRNMB, clinically relevant nonmajor bleeding; ESRD, end-stage renal disease; HR, hazard ratio; VTE, venous thromboembolism. a < 11 used due to agreements with commercial providers to assure privacy for very small number of…