Tags

Type your tag names separated by a space and hit enter

Effectiveness and Safety of Apixaban versus Warfarin as Outpatient Treatment of Venous Thromboembolism in U.S. Clinical Practice.
Thromb Haemost. 2018 Nov; 118(11):1951-1961.TH

Abstract

In the AMPLIFY clinical trial, apixaban was non-inferior to warfarin plus subcutaneous enoxaparin bridge therapy in the treatment of acute venous thromboembolism (VTE) and was associated with significantly less bleeding. This study evaluated their comparative effectiveness and safety in routine clinical practice. A matched-cohort design and data from four U.S. private health care claims databases were employed. Study population comprised patients who initiated outpatient treatment with apixaban versus warfarin (plus parenteral anticoagulant bridge therapy) within 30 days of their initial VTE episode; apixaban and warfarin patients were matched on age, characteristics of VTE episode, study database and propensity score. Major bleeding, clinically relevant non-major (CRNM) bleeding and recurrent VTE during the 180-day (maximum) follow-up period were compared using shared frailty models. During mean follow-up of 143 days among apixaban patients (n = 17,878) and 152 days among warfarin patients (n = 17,878), incidence proportions for apixaban versus warfarin, respectively, were 1.7% versus 2.3% for major bleeding, 7.0% versus 9.4% for CRNM bleeding and 2.3% versus 2.9% for recurrent VTE. In shared frailty models, risks of major bleeding (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.64-0.87), CRNM bleeding (HR = 0.77, 95% CI = 0.71-0.83) and recurrent VTE (HR = 0.80, 95% CI = 0.70-0.91) were lower for apixaban versus warfarin. In this large-scale evaluation of VTE patients receiving outpatient treatment with apixaban or warfarin in U.S. clinical practice, risks of major bleeding, CRNM bleeding and recurrent VTE were significantly lower among patients who received apixaban.

Authors+Show Affiliations

Policy Analysis Inc. (PAI), Brookline, Massachusetts, United States.Bristol-Myers Squibb, Lawrenceville, New Jersey, United States.Bristol-Myers Squibb, Lawrenceville, New Jersey, United States.Pfizer Inc., New York, New York, United States.Bristol-Myers Squibb, Lawrenceville, New Jersey, United States.Pfizer Inc., Groton, Connecticut, United States.Bristol-Myers Squibb, Lawrenceville, New Jersey, United States.Pfizer Inc., New York, New York, United States.Bristol-Myers Squibb, Wallingford, Connecticut, United States.Bristol-Myers Squibb, Lawrenceville, New Jersey, United States.Policy Analysis Inc. (PAI), Brookline, Massachusetts, United States.Policy Analysis Inc. (PAI), Brookline, Massachusetts, United States.Guy's and St. Thomas' Hospitals, London, United Kingdom.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

30357780

Citation

Weycker, Derek, et al. "Effectiveness and Safety of Apixaban Versus Warfarin as Outpatient Treatment of Venous Thromboembolism in U.S. Clinical Practice." Thrombosis and Haemostasis, vol. 118, no. 11, 2018, pp. 1951-1961.
Weycker D, Li X, Wygant GD, et al. Effectiveness and Safety of Apixaban versus Warfarin as Outpatient Treatment of Venous Thromboembolism in U.S. Clinical Practice. Thromb Haemost. 2018;118(11):1951-1961.
Weycker, D., Li, X., Wygant, G. D., Lee, T., Hamilton, M., Luo, X., Vo, L., Mardekian, J., Pan, X., Burns, L., Atwood, M., Hanau, A., & Cohen, A. T. (2018). Effectiveness and Safety of Apixaban versus Warfarin as Outpatient Treatment of Venous Thromboembolism in U.S. Clinical Practice. Thrombosis and Haemostasis, 118(11), 1951-1961. https://doi.org/10.1055/s-0038-1673689
Weycker D, et al. Effectiveness and Safety of Apixaban Versus Warfarin as Outpatient Treatment of Venous Thromboembolism in U.S. Clinical Practice. Thromb Haemost. 2018;118(11):1951-1961. PubMed PMID: 30357780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness and Safety of Apixaban versus Warfarin as Outpatient Treatment of Venous Thromboembolism in U.S. Clinical Practice. AU - Weycker,Derek, AU - Li,Xiaoyan, AU - Wygant,Gail DeVecchis, AU - Lee,Theodore, AU - Hamilton,Melissa, AU - Luo,Xuemei, AU - Vo,Lien, AU - Mardekian,Jack, AU - Pan,Xianying, AU - Burns,Leah, AU - Atwood,Mark, AU - Hanau,Ahuva, AU - Cohen,Alexander T, Y1 - 2018/10/24/ PY - 2018/10/26/entrez PY - 2018/10/26/pubmed PY - 2019/1/12/medline SP - 1951 EP - 1961 JF - Thrombosis and haemostasis JO - Thromb. Haemost. VL - 118 IS - 11 N2 - In the AMPLIFY clinical trial, apixaban was non-inferior to warfarin plus subcutaneous enoxaparin bridge therapy in the treatment of acute venous thromboembolism (VTE) and was associated with significantly less bleeding. This study evaluated their comparative effectiveness and safety in routine clinical practice. A matched-cohort design and data from four U.S. private health care claims databases were employed. Study population comprised patients who initiated outpatient treatment with apixaban versus warfarin (plus parenteral anticoagulant bridge therapy) within 30 days of their initial VTE episode; apixaban and warfarin patients were matched on age, characteristics of VTE episode, study database and propensity score. Major bleeding, clinically relevant non-major (CRNM) bleeding and recurrent VTE during the 180-day (maximum) follow-up period were compared using shared frailty models. During mean follow-up of 143 days among apixaban patients (n = 17,878) and 152 days among warfarin patients (n = 17,878), incidence proportions for apixaban versus warfarin, respectively, were 1.7% versus 2.3% for major bleeding, 7.0% versus 9.4% for CRNM bleeding and 2.3% versus 2.9% for recurrent VTE. In shared frailty models, risks of major bleeding (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.64-0.87), CRNM bleeding (HR = 0.77, 95% CI = 0.71-0.83) and recurrent VTE (HR = 0.80, 95% CI = 0.70-0.91) were lower for apixaban versus warfarin. In this large-scale evaluation of VTE patients receiving outpatient treatment with apixaban or warfarin in U.S. clinical practice, risks of major bleeding, CRNM bleeding and recurrent VTE were significantly lower among patients who received apixaban. SN - 2567-689X UR - https://www.unboundmedicine.com/medline/citation/30357780/Effectiveness_and_Safety_of_Apixaban_versus_Warfarin_as_Outpatient_Treatment_of_Venous_Thromboembolism_in_U_S__Clinical_Practice_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0038-1673689 DB - PRIME DP - Unbound Medicine ER -