Clinical utility of apixaban in the prevention and treatment of venous thromboembolism: current evidence

Abstract

Anticoagulation with heparin and vitamin K antagonist has been the mainstay of prevention and treatment of venous thromboembolism (VTE) for many years. In recent years, novel oral anticoagulants such as dabigatran etexilate (a direct thrombin inhibitor) and rivaroxaban, apixaban, and edoxaban (a direct factor Xa inhibitor) have emerged for the prevention and treatment of VTE. Novel oral anticoagulants have been shown to be noninferior to vitamin K antagonist or heparin in the prevention and treatment of VTE. This review specifically examines the role of apixaban in the prevention and treatment of VTE based on the available literature. The management of apixaban in the perioperative setting is also explored because some patients on apixaban may require surgical intervention. Finally, we discuss the management of apixaban-induced major bleeding complications, the relevance of drug–drug interactions, and patient education.

Keywords:

• new oral anticoagulants
• apixaban
• venous thromboembolism
• thromboprophylaxis

Acknowledgments

The authors thank the University of Texas MD Anderson Cancer Center’s Department of Scientific Publications for editing this paper.

Disclosure

The authors report no conflicts of interest in this work.