Key result
Apixaban is linked to ~46% lower recurrent VTE risk vs warfarin in severe obesity.
Why the study?
There is limited evidence supporting the use of apixaban for VTE treatment in patients with severe obesity defined by BMI ≥40 kg/m2 or weight ≥120 kg.
Does apixaban reduce recurrent VTE compared to warfarin in patients with severe obesity and acute VTE?
Population
1099 patients with VTE and severe obesity (BMI ≥40 kg/m2 or weight ≥120 kg)
Comparison
Apixaban versus warfarin
Design
Multi-center retrospective cohort study
Follow-up
12 months
Authors
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Apixaban may be considered over warfarin for VTE in severe obesity; hypothesis-generating and should not yet change practice.
Cohort (n=1,099)
Yes
Does apixaban reduce recurrent VTE compared to warfarin in patients with severe obesity and acute VTE?
Hazard Ratio: 0.54 (95% CI 0.29–0.97)
p-value: p=0.04
In patients with severe obesity and acute VTE, apixaban is associated with a significantly reduced risk of recurrent VTE compared to warfarin, without increasing bleeding risk.
Crouch et al. (2021) conducted a cohort in Venous thromboembolism (VTE) in severe obesity (n=1,099). Apixaban vs. Warfarin was evaluated on Time to recurrence of VTE within 12 months (HR 0.54, 95% CI 0.29-0.97, p=0.04). In patients with severe obesity and VTE, apixaban use was associated with a reduced risk of recurrent VTE compared to warfarin (HR 0.54; 95% CI 0.29-0.97; p=0.04).
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