Preventing Venous Thromboembolism with Apixaban in High-Risk Individuals
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on October 17th, 2025
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For patients with low risk venous thromboembolism provoked by cancer or thrombophilia, anticoagulants could be used for 3 months. However, it is currently unclear of the appropriate anticoagulant duration for low risk venous thromboembolism provoked by obesity, surgery, or immobility. With funding from Bristol-Myers Squibb & Pfizer, a study was implemented to determine the optimal schedule of apixaban to prevent transient provoked venous thromboembolism.
The clinical study included 600 participants with an average age of 59.5 years old who had at least one venous thromboembolism provoking factor, including major surgery, trauma, acute medical illness, or immobility. 20.8% of the participants had previously experienced at least one episode of venous thromboembolism, and 25.7% of them had a family history of the condition. Dyslipidemia & hypertension are some of the most common coexisting conditions, with half of the participants being affected. At baseline and throughout the experiment, around 20% of the patients were taken aspirin at a daily dose less than 81 mg.
The participants were randomly assigned to be treated with either placebo or apixaban at a dose of 2.5 mg, twice daily. The anticoagulant property of apixaban depends on its inhibition of Factor Xa. This prevents the clotting factor from catalyzing the conversion of prothrombin to thrombin. After 12 months of treatment, the researchers found that apixaban significantly reduces the risk of venous thromboembolism by 87%. Specifically, the medication was effective at reducing the risk of deep vein thrombosis & pulmonary embolism. However, it is important to note that apixaban slightly increases the risk of nonmajor bleeding.
The clinical study included 600 participants with an average age of 59.5 years old who had at least one venous thromboembolism provoking factor, including major surgery, trauma, acute medical illness, or immobility. 20.8% of the participants had previously experienced at least one episode of venous thromboembolism, and 25.7% of them had a family history of the condition. Dyslipidemia & hypertension are some of the most common coexisting conditions, with half of the participants being affected. At baseline and throughout the experiment, around 20% of the patients were taken aspirin at a daily dose less than 81 mg.
The participants were randomly assigned to be treated with either placebo or apixaban at a dose of 2.5 mg, twice daily. The anticoagulant property of apixaban depends on its inhibition of Factor Xa. This prevents the clotting factor from catalyzing the conversion of prothrombin to thrombin. After 12 months of treatment, the researchers found that apixaban significantly reduces the risk of venous thromboembolism by 87%. Specifically, the medication was effective at reducing the risk of deep vein thrombosis & pulmonary embolism. However, it is important to note that apixaban slightly increases the risk of nonmajor bleeding.