Cancer medicine
Efficacy and Safety of Apixaban Thromboprophylaxis According to Baseline Chemotherapy Class in High-Risk Ambulatory Cancer Patients: A Post Hoc Analysis of the AVERT Trial
By Feng NL, Doering J, Wang TF and 8 others.
Abstract
Background
Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in cancer patients. The AVERT trial showed apixaban thromboprophylaxis reduced VTE in intermediate-to-high-risk patients initiating chemotherapy. However, the efficacy and safety of apixaban according to baseline chemotherapy class remain incompletely characterized.
Methods
We conducted a post hoc analysis stratified by chemotherapy class of the randomized, double-blind, placebo-controlled AVERT trial comparing apixaban (2.5 mg twice daily) with placebo in ambulatory cancer patients initiating chemotherapy. The primary efficacy outcome was VTE, and the primary safety outcome was clinically relevant bleeding (major or clinically relevant non major bleeding (CRNMB)) per ISTH criteria. A subgroup analysis compared platinum-based with non-platinum chemotherapy. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CI), adjusted for age, sex, and study site. Treatment-by-platinum interaction terms were used to assess effect modification by platinum exposure.