Treatment and secondary prevention of venous thromboembolic complications: positions of apixaban

N.M. Vorobyeva, O.N. Tkacheva

Russian Gerontological Research and Clinical Center, Pirogov Russian National Research Medical University, Moscow, Russia

The review discusses the possibilities of using the direct-acting oral anticoagulant apixaban for the treatment and secondary prevention of venous thromboembolic complications (VTEC). The results of randomized clinical trials (RCTs), meta-analyses of RCTs and real-world clinical practice studies demonstrate a favorable efficacy and safety profile of apixaban for the treatment and secondary prevention of VTEC, incl. in patients with malignant neoplasms, who are characterized by a high risk of not only thrombosis, but also bleeding. For all patients with VTEC, apixaban is safer than standard therapy with enoxaparin/warfarin, because the risk of major bleeding associated with its use is lower by 69%, and in patients with active cancer, the safety of apixaban is not inferior to that of standard treatment. An important advantage of apixaban is the absence of an increase in the frequency of gastrointestinal bleeding in patients with cancer-associated thrombosis.

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About the Authors

Corresponding author: Natalya M. Vorobyova, Dr. Sci. (Med.), Senior Researcher at the Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontological Research and Clinical Center, Pirogov Russian National Research Medical University, Moscow, Russia; natalyavorobjeva@mail.ru

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