Apixaban: the added X-factor in anticoagulation

Apixaban, an orally active, highly selective, reversible inhibitor of coagulation Factor Xa, is effective in the prevention of venous thromboembolic events (VTE) in patients undergoing knee replacement surgery, according to data from a phase II dose-response study presented at the 48th Annual Meeting and Exposition of the American Society of Hematology (ASH) [Orlando, Florida, US; December 2006]. The combined incidence of total VTE (asymptomatic or symptomatic deep vein thrombosis or pulmonary embolism) and all-cause mortality during the treatment period was significantly lower in the apixaban groups combined, compared with the enoxaparin sodium and warfarin treatment groups. When once-daily and twice-daily dosing regimens of apixaban were combined as total daily dosages of 5, 10, or 20 mg/day, a trend towards statistical significance for a dose-dependent decrease in the combined incidence of total VTE and all-cause mortality was observed. The incidences of major bleeding events in patients treated with apixaban were low; no major bleeding events were observed in the enoxaparin or warfarin treatment groups.