Mazou Ngou Temgoua: Why Does Apixaban Cause Less Bleeding than Rivaroxaban?
Mazou Ngou Temgoua, Contract hospital practitioner at Châteauroux-Le Blanc Hospital Center, shared on LinkedIn about a recent article by Lana A. Castellucci et al, adding:
“Why does apixaban cause less bleeding than rivaroxaban?
A recent trial in VTE shows a lower incidence of bleeding with apixaban compared to rivaroxaban.
But the real question lies elsewhere:
Where does this difference come from?
Several avenues:
1. Pharmacokinetics
- Apixaban is given in 2 doses – more stable concentrations
- Rivaroxaban in 1 dose – higher plasma peaks
2. Intensity of factor Xa inhibition
A more ‘smoothed’ inhibition could further preserve physiological hemostasis
3. Induction Diagram (highlighted in this article)
- 7 days for apixaban
- 21 days for rivaroxaban
Are we really comparing two molecules… or two anticoagulation strategies?
Key Message:
- If the difference is related to the schema, it is potentially modifiable.
And this opens up a simple question:
Should we rethink the initial phase of rivaroxaban in VTE?
The answer is not yet known.
But the debate deserves to be asked.
And you, what is your reading?”
Title: Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism
Authors: Lana A. Castellucci, Vivien M. Chen, Michael J. Kovacs, Alejandro Lazo-Langner, Peter Greenstreet, Susan Kahn, Benoit Côté, Sam Schulman, Kerstin de Wit, James Douketis, Deepa Suryanarayan, Tony Wan, Erik Yeo, Genevieve Le Templier, Huyen A. Tran, Abbey Willcox, Helen J. Crowther, Ritam Prasad, Sudeep Shivakumar, Etimbuk Umana, Fionnuala Ni Ainle, Tobias Tritschler, Stefano Barco, Jean-Philippe Galanaud, Marc Blondon, Lisa Baumann Kreuziger, Susan Solymoss, Clive Kearon, Erin Thomas, Tim Ramsay, Gregoire Le Gal, Marc Rodger
Read the Full Article on NEJM
Stay updated with Hemostasis Today.
-
Sep 25, 2026, 09:49Haley Coleman: Volunteering to Support Hemophilia Awareness
-
Sep 25, 2026, 08:55Hitarth Mehta: BHMS Students Gain Practical Exposure to Haemophilia Diagnosis
-
Sep 25, 2026, 07:25Varun Capoor: How Therapeutic Apheresis and Transfusion Medicine Can Complement Clinical Management in SCD
-
Sep 25, 2026, 07:14Manshi Kesharwani: SAK-GQDs Modulate Thrombus Burden and Endothelial Function in Deep Vein Thrombosis
-
Sep 25, 2026, 06:20Farjah Hassan Algahtani: How Can We Better Identify Patients at Risk of Blood Clots after Metabolic and Bariatric Surgery?
-
Sep 25, 2026, 05:59Carla Lewis: Kids Conquering Sickle Disease Joins Nemours Children’s Hospital for 2nd Annual Awareness Event
-
Sep 25, 2026, 05:47Omid Seidizadeh: Evolutionary Constraint and Population Variation Across Coagulation Genes
-
Sep 25, 2026, 05:40Gerald Bertrand: Presenting UMi-NGS Non-Invasive Foetal HPA Genotyping at DGTI 2026
-
Sep 25, 2026, 05:33Urge Congress to support the Sickle Cell Disease Comprehensive Care Act – ASH