A comprehensive evaluation of apixaban in the treatment of venous thromboembolism.

This article reviews results from preclinical and healthy volunteer studies that illustrate the noteworthy properties of apixaban such as a proportional dose-response relationship, low daily fluctuation in plasma concentrations, and safety over a 10-fold dosing range. Additionally, the large phase III trials evaluating the safety and efficacy of apixaban compared to low molecular weight heparin (LMWH) overlapped with and followed by vitamin K antagonist (VKA) warfarin for the treatment and secondary prevention of VTE will be discussed. The key studies that have led to apixaban's current licensing and use will be highlighted including the trials in the acute treatment of VTE where apixaban demonstrated noninferior efficacy and a reduced risk of bleeding in comparison to VKA, and in extended prophylaxis trials where apixaban reduced the risk of VTE/VTE-related deaths, with no increased risk of relevant bleedings in comparison to placebo. This review also will provide an overview of special populations where future areas of research is needed.Expert Commentary: Apixaban offers several advantages over historical therapy for the treatment and secondary prevention of VTE and is currently considered and widely used in many countries, along with other DOACs, as first line therapy for this indication. Importantly, there are many populations in which the use of apixaban has not been extensively studied. Large clinical trials had a low representation of patients > 75 years old, with ...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research