Thromb Haemost 2016; 115(01): 161-168
DOI: 10.1160/TH15-07-0606
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH Schattauer

Extended anticoagulation with apixaban reduces hospitalisations in patients with venous thromboembolism

An analysis of the AMPLIFY-EXT trial
Xianchen Liu
1   Pfizer Inc., New York, New York, USA
,
John Thompson
2   Pfizer Inc., Groton, Conneticut, USA
,
Hemant Phatak
3   Bristol-Myers Squibb Inc., Princeton, New Jersey, USA
,
Jack Mardekian
1   Pfizer Inc., New York, New York, USA
,
Anthony Porcari
2   Pfizer Inc., Groton, Conneticut, USA
,
Margot Johnson
2   Pfizer Inc., Groton, Conneticut, USA
,
Alexander T. Cohen
4   Guy’s and St Thomas’ Hospitals, Westminster Bridge Road, London, UK
› Author Affiliations
Financial support:This study was funded by Pfizer Inc. and Bristol-Myers Squibb Company.
Further Information

Publication History

Received: 30 July 2015

Accepted after minor revision: 18 September 2015

Publication Date:
22 November 2017 (online)

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Summary

Treatment with apixaban versus placebo for 12 months significantly reduced symptomatic recurrent venous thromboembolism (VTE) or all-cause death without increasing the rate of major bleeding in the AMPLIFY-EXT trial. This analysis examined the effects of apixaban versus placebo on the rate of all-cause hospitalisations, time to first hospitalisation, and predictors of first hospitalisation in patients with VTE enrolled in AMPLIFY-EXT. Treatment with apixaban 2.5 mg and 5 mg twice daily significantly reduced the rate of all-cause hospitalisations versus placebo (hazard ratio [95 % confidence interval], 0.64 [0.43, 0.95]; p=0.026 and 0.54 [0.36, 0.82]; p=0.004, respectively). Apixaban prolonged mean time to first hospitalisation versus placebo by 43 and 49 days for the 2.5-mg and 5-mg twice-daily groups, respectively. Median length of hospital stay during the first hospitalisation was longer for placebo than for apixaban 2.5 mg or 5 mg twice daily (7.0, 5.0, and 4.5 days, respectively). Treatment with apixaban was a significant predictor of lower rates of hospitalisations versus placebo, and severe/moderate renal impairment was a significant predictor of an increased rate. This study supports extended use of apixaban for reducing all-cause hospitalisations and extending time to first hospitalisation in patients with VTE enrolled in AMPLIFY-EXT (www.clinical trials.gov registration: #NCT00633893).

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