Reduced-Dose Apixaban Effectively Prevents Venous Thromboembolism in Cancer Patients
|
Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on May 7th, 2025
|
Patients with cancer face a significantly higher risk of venous thromboembolism compared to their healthy counterparts. Although many current guidelines recommend continued anticoagulation throughout the duration of cancer, prolonged therapy increases the risk of bleeding complications. To explore an optimal dosing strategy, a study funded by Bristol-Myers Squibb was conducted to evaluate the efficacy and safety of different apixaban dosing regimens in preventing thromboembolism among cancer patients.
The clinical trial enrolled 1,766 participants who had various types of cancer and a history of venous thromboembolism. Breast cancer was the most common diagnosis (approximately 23%), followed by colorectal (15%), lung (11%), and prostate cancer (9%). Two-thirds of the participants had metastatic disease. Performance status assessed by the Eastern Cooperative Oncology Group (ECOG) scale showed that around 37% had a score of 1, and 7% had a score of 2, indicating they were ambulatory but limited in their ability to perform daily activities.
Participants were randomly assigned to receive apixaban either at the standard dose of 5.0 mg twice daily or a reduced dose of 2.5 mg twice daily. Apixaban is a direct oral anticoagulant that inhibits factor Xa, thereby preventing the conversion of prothrombin to thrombin, a key step in fibrin clot formation. After approximately one year of treatment, researchers found that venous thromboembolism recurrence occurred in 2.1% of patients treated with the reduced dose and 2.8% of those treated with the full dose, demonstrating that the reduced dose was similarly effective. Importantly, the reduced dose was associated with a 25% lower risk of bleeding complications.
The clinical trial enrolled 1,766 participants who had various types of cancer and a history of venous thromboembolism. Breast cancer was the most common diagnosis (approximately 23%), followed by colorectal (15%), lung (11%), and prostate cancer (9%). Two-thirds of the participants had metastatic disease. Performance status assessed by the Eastern Cooperative Oncology Group (ECOG) scale showed that around 37% had a score of 1, and 7% had a score of 2, indicating they were ambulatory but limited in their ability to perform daily activities.
Participants were randomly assigned to receive apixaban either at the standard dose of 5.0 mg twice daily or a reduced dose of 2.5 mg twice daily. Apixaban is a direct oral anticoagulant that inhibits factor Xa, thereby preventing the conversion of prothrombin to thrombin, a key step in fibrin clot formation. After approximately one year of treatment, researchers found that venous thromboembolism recurrence occurred in 2.1% of patients treated with the reduced dose and 2.8% of those treated with the full dose, demonstrating that the reduced dose was similarly effective. Importantly, the reduced dose was associated with a 25% lower risk of bleeding complications.