A study published in the American Journal of Hematology compared the effectiveness of three oral anticoagulants—apixaban, rivaroxaban, and warfarin—in older adults recovering from venous thromboembolism (VTE). The research analyzed Medicare claims data from 2015 to 2019 for over 18,000 patients.
Key Findings
Patients treated with apixaban experienced fewer major complications and spent more days at home compared to those treated with warfarin.
Apixaban was associated with a lower combined risk of recurrent blood clots or death within one year, as well as lower rates of major bleeding.
Rivaroxaban showed no clear advantage over warfarin for preventing complications and was associated with greater loss of home time than apixaban.
The benefits of apixaban were observed in both frail and non-frail older adults, with the clearest benefits among non-frail patients.
Study Details
Lead author Chanmi Park, MD, MPH, from the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, led the research.
The study measured "home time loss," capturing days spent in hospitals, emergency departments, skilled nursing facilities, or lost due to death within 365 days.
Researchers combined frailty measures with clinical outcomes and patient-centered measures to guide treatment decisions.
Statement
"Our findings suggest that apixaban may offer a favorable balance of effectiveness, safety, and the ability for patients to remain at home, which is an outcome that matters greatly to older adults and their families."
— Chanmi Park, MD, MPH