The ADOPT trial investigators have reported that 30 days of apixaban thromboprophylaxis is associated with a similar 30-day rate of death related to venous thromboembolism, pulmonary embolism, symptomatic deep-vein thrombosis, or asymptomatic proximal-leg deep-vein thrombosis as 6–14 days of enoxaparin (2.71% vs 3.06%; relative risk 0.87, 95% CI 0.62–1.23, P = 0.44) in medically ill patients. Furthermore, by day 30, apixaban was associated with more major bleeding than enoxaparin (0.47% vs 0.19%; relative risk 2.58, 95% CI 1.02–7.24, P = 0.04). However, the authors highlight that “the ADOPT trial was underpowered”, and believe that, “even though [the] trial was negative, the strategy of extended prophylaxis with apixaban may have promise”.
ORIGINAL RESEARCH PAPER
Goldhaber, S. Z. et al. Apixaban versus enoxaparin for thromboprophylaxis in medically ill patients. N. Engl. J. Med. doi:10.1056/NEJMoa1110899
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Extended prophylaxis with apixaban is not superior to short-course enoxaparin therapy in medically ill patients. Nat Rev Cardiol 9, 6 (2012). https://doi.org/10.1038/nrcardio.2011.190
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DOI: https://doi.org/10.1038/nrcardio.2011.190