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Amy Delderfield: One Trial, Big Implications for Anticoagulant Choice
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.”

Amy Delderfield: One Trial, Big Implications for Anticoagulant Choice

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Amy Delderfield Apixaban Apixaban vs Rivaroxaban COBRRA Health Hematology Hemostasis News Hemostasis Today Medicine NEJM Rivaroxaban VTE
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