Apixaban Demonstrates Less Bleeding in Patients With Acute VTE vs Rivaroxaban

Background: Venous thromboembolism (VTE) is a leading cause of cardiovascular morbidity and mortality worldwide. Direct-acting oral anticoagulants (DOACs), including apixaban and rivaroxaban, are noninferior regarding efficacy with less bleeding risk compared to vitamin K antagonists. It is uncertain if one DOAC is better than another. Objective: To compare apixaban versus rivaroxaban regarding safety in patient with acute VTE. Design: Pragmatic, international COBRRA (Comparison of Bleeding Risk between Rivaroxaban and Apixaban) trial (32 sites in Canada, Australia, and Ireland) with a prospective, randomized, open-label, blinded end point design comparing apixaban versus rivaroxaban in patients with acute VTE. Participants: Patients aged ≥18 years with acute lower-limb deep vein thrombosis (DVT) and/or acute pulmonary embolism (PE). Important exclusion criteria were therapeutic anticoagulation for >72 hours before enrollment, creatinine clearance of Methods: Patients were randomi more...