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

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

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