Amy Delderfield/LinkedIn
Mar 28, 2026, 18:41
Amy Delderfield: One Trial, Big Implications for Anticoagulant Choice
Amy Delderfield, Founder of Medicine Central, STEM Advisor to the UN, shared a post on LinkedIn:
“3.3 percent versus 7.1 percent…
That’s the bleeding rate in the first ever randomized head-to-head comparison of apixaban vs rivaroxaban for VTE.
RR 0.46 (95 percent CI 0.33 to 0.65; P<0.001).
For over a decade we’ve treated them as interchangeable.
The COBRRA trial, just published in the NEJM, suggests they’re not.
- 2,760 patients.
- 54 percent relative risk reduction in clinically relevant bleeding with apixaban.
- No difference in clot recurrence.
Could it be down to the dosing?
Rivaroxaban’s loading phase is longer and higher.
One trial.
But a big one.
Concise breakdown and what is means for primary care clinicians here.
Intended for Healthcare Professionals.”

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