Apixaban: Low-Dose Long-Term Use After Provoked VTE Shows Benefits
Christopher Cannon, Editor in Chief, Harvard Health Publishing, shared a post on LinkedIn:
“Low-dose Apixaban long-term following a “provoked” VTE is beneficial.
I think that practice will change – from stopping anticoagulation after a period of initial treatment, to reducing to 1/2 dose for long-term prevention.
This has been my practice for “unprovoked” DVT/PE based on a host of other trials, but this study now extends this: it looked at those with a transient factor like surgery, trauma or immobility – but with an enduring risk factor: ASCVD, Obesity, Heart failure (systolic, diastolic, or combined, lung disease(COPD, asthma, interstitial lung disease), Chronic kidney disease (eGFR <60 mL/min/1.72m2)
Chronic inflammatory/autoimmune disorder (inflammatory arthritis, vasculitis, inflammatory bowel disease, chronic infection) or Persistent immobility. That covers a lot of patients.
Younger, healthy patients who have “provoked” VTE. e.g., post surgery or immobility- they would be ones where stopping after an initial period of anticoagulation is reasonable.
Congratulations Gregory Piazza, Samuel Z. Goldhaber, MD and colleagues!”
Read full article here.
Title: Apixaban for Extended Treatment of Provoked Venous Thromboembolism
Authors: Gregory Piazza, Behnood Bikdeli, Arvind K. Pandey, Darsiya Krishnathasan, Candrika D. Khairani, Antoine Bejjani, Ruth H. Morrison
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