Apixaban outperformed rivaroxaban for efficacy and safety in a recent trial.

Apixaban and rivaroxaban are both direct-acting oral anticoagulants, increasingly prescribed in modern practice. Using data from adults with newly diagnosed venous thromboembolism (deep vein thrombosis or pulmonary embolism) who were new users of apixaban or rivaroxaban, American researchers have recently compared key outcomes with the two drugs. In essence, apixaban outperformed rivaroxaba. The crude incidence of recurrent venous thromboembolism was three per 100 person-years for apixaban and seven per 100 person-years for rivaroxaban, whilst major bleeding was observed at a rate of three per 100 person-years in the apixaban group and six per 100 person-years in the rivaroxaban group. Using multivariable Cox regression models, compared to rivaroxaban, associated with decreased risk of recurrent venous thromboembolism (HR 0·37 [95% CI 0·24-0·55]; p<0·0001) and major bleeding events (0·54 [0·37-0·82]; p=0·0031). The full study, published in Lancet Haematology, can be viewed here.