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Betrixaban for first-line venous thromboembolism prevention in acute medically ill patients with risk factors for venous thromboembolism.
Expert Rev Cardiovasc Ther. 2018 Oct 08;:
Authors: Nafee T, Gibson CM, Yee MK, Alkhalfan F, Chi G, Travis R, Mir M, Kalayci A, Jafarizade M, Ganti A, Kazmi SH, Ghaffarpasand E, Pitliya A, Datta S, Sharfaei S, Alihashemi M, Elsaiey A, Qamar I, Jahansouz M, Talib U, Kahe F, Habibi S, Abdelwahed M, Tariq F, Kaur M, Younes A, Walia SS, Singh A, Dildar SM, Afzal MK, Kerneis M
Abstract
INTRODUCTION: Compared to other direct oral anticoagulants (DOACs), betrixaban has a longer half-life, smaller peak-trough variance, minimal renal clearance, and minimal hepatic CYP metabolism. The Acute Medically Ill VTE Prevention with Extended Duration Betrixaban (APEX) trial evaluated the efficacy and safety of extended duration betrixaban compared to standard duration enoxaparin in acutely ill hospitalized patients. Areas covered: This article describes the role of betrixaban in the prevention of venous thromboembolism (VTE) in acutely ill medical patients. This article provides a consolidated summary of the primary APEX study findings as well as pre-specified and exploratory substudies. This article also provides a review of the results of studies in which other direct Factor Xa inhibitors have been evaluated in an extended duration regimen in this patient population. Expert commentary: While previous agents have demonstrated that extended duration VTE prophylaxis can be efficacious, betrixaban is the first agent to demonstrate efficacy without an increase in major bleeding. The totality of the data from the APEX trial supports extended duration betrixaban for VTE prophylaxis in the acute medically ill patient population. As such, betrixaban has been approved in the USA for extended VTE prophylaxis in at-risk acute medically ill patients.
PMID: 30296387 [PubMed - as supplied by publisher]