Apixaban for Acute DVT Treatment

Efficacy and Safety

• The American College of Chest Physicians recommends apixaban over enoxaparin for the treatment of acute deep vein thrombosis (DVT) in non-cancer patients due to its comparable efficacy and significantly lower bleeding risk 1
• Apixaban has been shown to be non-inferior to conventional therapy (enoxaparin followed by warfarin) for the treatment of acute venous thromboembolism (VTE) including DVT 1

Special Populations

• For patients with DVT and active cancer, low molecular weight heparin (LMWH) such as enoxaparin is still suggested over apixaban (Grade 2C) 1
• Apixaban should be used with caution in patients with severe renal impairment (CrCl <15 mL/min) as these patients were excluded from clinical trials 2

Guideline Recommendations

• The American College of Chest Physicians suggests using a direct oral anticoagulant (DOAC) such as apixaban in preference to vitamin K antagonist therapy for the initial and long-term treatment of VTE in patients without cancer 1
• The European Society of Cardiology (ESC) guidelines also support the use of DOACs like apixaban for the treatment of acute DVT 4