Evidence map›Paper›PMID 36811795›Full record

ArticleAdvances in therapy2023

Effectiveness and Safety of Apixaban vs Warfarin in Patients with Venous Thromboembolism with Risk Factors for Bleeding or for Recurrences.

Alexander T Cohen, Janvi Sah, Amol D Dhamane, Dionne M Hines, Theodore Lee, Lisa Rosenblatt, Birol Emir, Allison Keshishian, Huseyin Yuce, Xuemei Luo

Open access · hybridAbstract read
In one paragraph

Article in Advances in therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Alexander T CohenDepartment of Hematological Medicine, Guy's & St Thomas' NHS Foundation Trust, King's College London, Westminster Bridge Road, London, UK. alexander.cohen@kcl.ac.uk.ORCID http://orcid.org/0000-0002-9398-4621
Janvi SahSTATinMED, LLC, Dallas, TX, USA.
Amol D DhamaneBristol Myers Squibb Company, Lawrenceville, NJ, USA.
Dionne M HinesPfizer Inc., New York, NY, USA.
Theodore LeePfizer Inc., New York, NY, USA.
Lisa RosenblattBristol Myers Squibb Company, Lawrenceville, NJ, USA.
Birol EmirPfizer Inc., New York, NY, USA.
Allison KeshishianSTATinMED, LLC, Dallas, TX, USA.
Huseyin YuceNew York City College of Technology, City University of New York, New York, NY, USA.
Xuemei LuoPfizer Inc., Groton, CT, USA.
Pfizer (United States) · USBristol-Myers Squibb (United States) · USSTATinMED (United States) · USCity University of New York · USKing's College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients at increased risk of bleeding and recurrent VTE who develop venous thromboembolism (VTE) present challenges for clinical management. This study evaluated the effectiveness and safety of apixaban vs warfarin in patients with VTE who have risk factors for bleeding or recurrences.

methodsAdult patients with VTE initiating apixaban or warfarin were identified from five claims databases. Stabilized inverse probability treatment weighting (IPTW) was used to balance characteristics between cohorts for the main analysis. Subgroup interaction analyses were conducted to evaluate treatment effects among patients with and without each of the conditions that increased the risk of bleeding (thrombocytopenia and history of bleed) or recurrent VTE (thrombophilia, chronic liver disease, and immune-mediated disorders).

resultsA total of 94,333 warfarin and 60,786 apixaban patients with VTE met selection criteria. After IPTW, all patient characteristics were balanced between cohorts. Apixaban (vs warfarin) patients were at lower risk of recurrent VTE (HR [95% confidence interval (CI) 0.72 [0.67-0.78]), major bleeding (MB) (HR [95% CI] 0.70 [0.64-0.76]), and clinically relevant non-major (CRNM) bleeding (HR [95% CI] 0.83 [0.80-0.86]). Subgroup analyses showed generally consistent findings with the overall analysis. For most subgroup analyses, there were no significant interactions between treatment and subgroup strata on VTE, MB and CRNM bleeding.

conclusionPatients with prescription fills for apixaban had lower risk of recurrent VTE, MB, and CRNM bleeding compared with warfarin patients. Treatment effects of apixaban vs warfarin were generally consistent across subgroups of patients at increased risk of bleeding/recurrences.

Indexed as

Venous ThromboembolismWarfarinAdultAnticoagulantsHemorrhageHumansPyrazolesPyridonesRisk FactorsAnticoagulantsapixabanPyrazolesPyridonesWarfarinApixabanMajor bleedingVTEWarfarin

Identifiers

PMID36811795
PMCPMC10070226
OpenAlexW4321491065

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.