apixaban / Generic mfg. - LARVOL DELTA

Thyrotoxicosis-Induced Chordal Rupture Causing Severe Mitral Regurgitation: Surgical Management and Outpatient Recovery. (PubMed, JACC Case Rep) - "Thyrotoxicosis can cause chordal rupture and flail leaflet. Repair is preferred, but replacement is appropriate when repair is not durable. Management requires endocrine-cardiac coordination and individualized antithrombotic therapy. Expect early ejection-fraction decline after surgical correction."

Journal • Atrial Fibrillation • Cardiovascular • Endocrine Cancer • Heart Failure

Optimizing PNH treatment with the complement inhibitor pegcetacoplan: A case report (ASH 2025) - "The current treatment landscape includes 6 approved complement cascade inhibitors: 3 C5 inhibitors (eculizumab, ravulizumab, crovalimab), 1 C3/C3b inhibitor (pegcetacoplan), 1 factor B inhibitor (iptacopan), and 1 factor D inhibitor used as add-on treatment (danicopan)...Concomitant medications included apixaban, penicillin, and folic acid. In November 2020, her platelets count declined, and a bone marrow evaluation was diagnostic for moderate aplastic anemia (55-65% cellularity for age) and she was started on eltrombopag and cyclosporin. Despite ravulizumab and eltrombopag treatments, the patient developed significant anemia related to extravascular hemolysis (hemoglobin, 5.7 g/dL; LDH, 495 U/L; C5, 26.1 mg/dL [high]; complement hemolytic activity 50 [CH50], 7 U/mL [low])...After receiving both pegcetacoplan and iptacopan for 1 week and rivaroxaban 10 mg once daily for 48 hours, pegcetacoplan treatment ended on May 16, 2024... For this patient with PNH, the..."

Case report • Clinical • Anorexia • Aplastic Anemia • Complement-mediated Rare Disorders • Hematological Disorders • Infectious Disease • Meningococcal Infections • Paroxysmal Nocturnal Hemoglobinuria • Rare Diseases

Efficacy and safety of low-dose vs. standard-dose direct oral anticoagulants for secondary prevention of cancer associated thrombosis: A systematic review and meta-analysis (ASH 2025) - " We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective and prospective observational studies evaluating reduced-dose apixaban (2.5 mg twice daily) or rivaroxaban (10 mg once daily), compared with standard-dose (5 mg twice daily for apixaban, 20 mg once daily for rivaroxaban) for the extended treatment of VTE. Extended-duration anticoagulation with reduced-dose DOACs in patients with active cancer demonstrated non-inferior efficacy for preventing recurrent VTE compared to full-dose regimens, with no significant differences in all-cause mortality, major bleeding, or clinically relevant non-major bleeding. In a randomized trial subgroup analysis, reduced-dose DOACs were associated with a lower risk of composite bleeding. These findings support the consideration of reduced-dose DOACs as a safer alternative for long-term anticoagulation in cancer patients."

Retrospective data • Review • Oncology • Thrombosis • Venous Thromboembolism

Real-world comparative bleeding outcomes of direct oral anticoagulants versus warfarin in adults: Insights from observational evidence (ASH 2025) - "Background: Direct oral anticoagulants (DOACs) – apixaban, rivaroxaban, dabigatran, and edoxaban– are increasingly preferred over warfarin for stroke prevention in atrial fibrillation and treatment of venous thromboembolism. This review provides robust real-world evidence that DOACs offer a superior safety and effectiveness profile compared to warfarin in adult patients requiring anticoagulation. DOACs significantly reduce the incidence of ICH and stroke– two of the most clinically devasting complications– while maintaining comparable or lower rates of major and GI bleeding. These findings validate guideline recommendations and strongly support the preferential use of DOACs as the standard of care for anticoagulation in everyday clinical practice."

Clinical • Real-world • Real-world evidence • Atrial Fibrillation • Cerebral Hemorrhage • CNS Disorders • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Venous Thromboembolism

Delayed pulmonary embolism following oocyte retrieval in invitro fertilization: A neglected risk factor for thromboembolic events? (ASH 2025) - "Treatment: The patient was managed with intravenous heparin with a subsequent transition to apixaban after stabilization. This case highlights the diagnostic dilemma and management of delayed PE in ART patients. It emphasizes the importance of early recognition and the need for a high index of suspicion for PE, even in the absence of classic risk factors. Prophylactic anticoagulation may be beneficial in ART patients who are at high risk to prevent thromboembolic events, particularly in those with additional risk factors."

Preclinical • Cardiovascular • Genetic Disorders • Gynecology • Hematological Disorders • Obesity • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Venous Thromboembolism

Navigating triple therapy in a high-risk cardiac patient with a covered stent and embolic stroke: A case report (ASH 2025) - "He was diagnosed with NSTEMI, and was initiated on aspirin, clopidogrel, enoxaparin, and nitroglycerin...Persistent cardiogenic shock necessitated Impella CP support, vasopressors (epinephrine, norepinephrine), and inotropes (dobutamine)...Following readmission, neurological evaluation revealed small subacute infarcts, following which anticoagulation with enoxaparin (later apixaban) was initiated alongside DAPT (aspirin, clopidogrel)...Repeat coronary angiography plays a major role here, allowing physicians to assess stent integrity and to make informed decision about de-escalation or continuation of therapy. Unfortunately, there are no current guidelines specifically addressing management strategies for patients with coronary artery aneurysms and recent embolic stroke, underscoring an urgent need for further research in this area."

Case report • Clinical • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Depression • Heart Failure • Hematological Disorders • Ischemic stroke • Nephrology • Peripheral Arterial Disease • Pulmonary Disease • Renal Disease • Respiratory Diseases • Thrombosis

Malignancy-associated internal jugular venous thrombosis following chemoradiation for oropharyngeal carcinoma (ASH 2025) - "Six months prior, he was diagnosed with HPV-positive (p16+) oropharyngeal SCC with nodal involvement, treated with carboplatin/fluorouracil chemotherapy and 14 days of radiation...Anticoagulation choice (apixaban) required careful consideration of renal function and bleeding risk (history of GI toxicity, anemia). This case underscores the heightened thrombotic risk in HNSCC patients due to the confluence of disease biology, aggressive local therapy, and patient-specific factors like CKD. Vigilance for atypical UEDVT presentations and individualized anticoagulation strategies are crucial in this complex population."

Cardiovascular • Chronic Kidney Disease • Dyslipidemia • Head and Neck Cancer • Hypertension • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Oncology • Oropharyngeal Cancer • Renal Disease • Solid Tumor • Squamous Cell Carcinoma • Squamous Cell Carcinoma of Head and Neck • Thrombosis • Venous Ulcer

Pulmonary vein thrombosis following bronchoscopic cryobiopsy: A case report (ASH 2025) - "His hemoptysis gradually resolved, and he was discharged on Apixaban... Pulmonary vein thrombosis is a rare but serious complication that may occur following bronchoscopic cryobiopsy. This case highlights the importance of recognizing this potential adverse outcome, especially in patients presenting with unexplained respiratory symptoms post-procedure. Early detection and anticoagulation are critical to managing this condition and preventing systemic embolization."

Case report • Clinical • Atrial Fibrillation • Cardiovascular • Cough • Diabetes • Fibrosis • Genetic Disorders • Hematological Malignancies • Hypertension • Immunology • Lymphoma • Metabolic Disorders • Obesity • Obstructive Sleep Apnea • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Sarcoidosis • Sleep Disorder • Thrombosis

Recurrent splenic infarction in triple-positive antiphospholipid syndrome despite therapeutic anticoagulation (ASH 2025) - "She was discharged on Apixaban. This case highlights the rarity of splenic infarction as an initial presentation of triple-positive APS. Although APS is commonly associated with thromboembolic events, splenic involvement is unusual and maybe easily overlooked. The patient's progression of infarcts, despite a therapeutic INR raised concern for possible warfarin resistance, a rare but important consideration in triple-positive APS."

Atrial Fibrillation • Cardiovascular • Genetic Disorders • Hematological Disorders • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Ischemic stroke • Obstetrics • Thrombocytopenia • Vasculitis

Evolving catastrophic antiphospholipid syndrome with intracerebral hemorrhage: Treatment with plasma exchange and rituximab (ASH 2025) - "Apixaban was discontinued; enoxaparin 1 mg/kg twice daily, aspirin, prednisone 1 mg/kg with taper, and rituximab 375 mg/m² weekly ×4 were initiated...He was bridged from enoxaparin to warfarin (INR goal 2–3) for indefinite anticoagulation given APS and atrial fibrillation...Given higher recurrent thrombosis with direct oral anticoagulants reported in highrisk APS, vitamin K antagonists remain preferred for longterm therapy when feasible; multidisciplinary coordination is essential to individualize immunomodulation, anticoagulant selection, and timing. Disclaimer The views expressed in this abstract are those of the author(s) and do not necessarily reflect the official policy or position of the Defense Health Agency, the Department of Defense, or the U.S. Government."

Acute Kidney Injury • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Complement-mediated Rare Disorders • Genetic Disorders • Hematological Disorders • Immunology • Inflammatory Arthritis • Ischemic stroke • Nephrology • Renal Disease • Thrombocytopenia • Thrombosis

Anticoagulation dilemma in a patient with nephrotic syndrome and bleeding of unknown origin: A case-based approach to risk-benefit decision-making (ASH 2025) - "She received four units of packed red blood cells, one dose of Venofer 200 mg, and was started on pantoprazole 40 mg IV twice daily... This case highlights the complexities of anticoagulation management in patients with nephrotic syndrome. Despite the indication for anticoagulation, the absence of a documented thrombotic event, stabilization of hemoglobin following Apixaban cessation, and a moderate bleeding risk favored cessation of therapy. Multidisciplinary input and shared decision-making were essential in aligning the treatment plan with the patient's evolving clinical status and preferences."

Benefit-risk assessment • Clinical • Cardiovascular • Chronic Kidney Disease • Gastroenterology • Gastrointestinal Disorder • Glomerulonephritis • Hematological Disorders • Immunology • Inflammation • Nephrology • Peripheral Arterial Disease • Renal Disease • Thrombosis

Is there an optimal time to transition to low dose direct oral anticoagulants? (ASH 2025) - "Background : Prophylactic-dose or low-dose apixaban and rivaroxaban have been studied in randomizedcontrolled trials for the extended prevention of venous thromboembolism (VTE) after 6 months oftreatment with therapeutic anticoagulation. This real-world patient population demonstrates that anticoagulant prescribers transition tolow-dose DOACs ahead of the historically studied 6-month time point. The results of this study do notindicate a significant difference in clinical outcomes of VTE recurrence or bleeding complications basedon time of transition to low-dose DOACs either before or after 6 months."

Venous Thromboembolism

Abbreviated anticoagulation regimen with direct oral anticoagulants is safe and efficacious in the management of infection-associated cerebral sinovenous thrombosis in children (ASH 2025) - "Forty-five (96%) patients were started on unfractionated heparin (UFH) orlow molecular weight heparin, and 15 (32%) were transitioned to rivaroxaban or apixaban. One patient died of an underlying malignancy.ConclusionOur data suggests that an abbreviated course of anticoagulation using DOACs is safe and efficacious inthe management of infection-associated CSVT in children. Additionally, thrombophilia work-up is lowyield and likely not indicated in this cohort."

Clinical • Cardiovascular • Infectious Disease • Otorhinolaryngology • Respiratory Diseases • Sinusitis • Thrombosis • Venous Thromboembolism

Reduced versus standard dose apixaban for secondary prevention of cancer-associated venous thromboembolism: A systematic review and meta-analysis (ASH 2025) - "These findings suggest that reduced-dose apixaban mayoffer a safer alternative for long-term anticoagulation in selected oncology patients. Further prospective,stratified studies are needed to validate these results and guide individualized anticoagulation strategiesin cancer-associated thrombosis."

Retrospective data • Review • Oncology • Respiratory Diseases • Venous Thromboembolism

Extended duration anticoagulation in cancer associated thrombosis (ASH 2025) - "Prophylactic dose of anticoagulation wasdefined as apixaban 2.5mg BD, rivaroxaban 10mg OD or enoxaparin 40mg OD (20mg OD for weight<50kg). Low dose anticoagulation is used in clinical practice for secondary thromboprophylaxis in patients withCAT without a signal for increased VTE recurrence and with low bleeding complications. Further data arerequired on the longer-term continuation of this thromboprophylactic strategy in an era when patientsare living longer with advanced cancer."

Oncology • Thrombosis

primary thromboprophylaxis using direct oral anti-coagulants (DOAC) in malignant pediatric tumors with vascular compression (ASH 2025) - "Sarangi previously demonstrated a reduction inthrombotic events for patients with mediastinal masses and tumor-related vascular compression (TRVC)who received prophylactic enoxaparin (Sarangi et...Fourteen patients (≥12 years and >40 kg) receivedapixaban (2.5 mg twice a day) and 5 patients received rivaroxaban (weight-based dosing)...On apixaban, 1 patient had rapid self-resolution of epistaxis, and another had hematuria withconcurrent ifosfamide administration...Though limited by its mostly retrospective design, small sample size, and single-institution population,our study highlights an at-risk subgroup of pediatric oncology patients with TRVC that may benefit fromuniversal primary thromboprophylaxis with a DOAC. Larger studies are needed to evaluate this further."

Clinical • Desmoid Tumors • Fibrosis • Hematological Malignancies • Lymphoma • Neuroblastoma • Obesity • Oncology • Pediatrics • Sarcoma • Solid Tumor • Venous Thromboembolism

Efficacy and safety of low-dose vs. standard-dose direct oral anticoagulants for secondary prevention of venous thromboembolism: A systematic review and meta-analysis (ASH 2025) - "This meta-analysisevaluates the efficacy and safety of reduced-dose versus standard-dose DOACs for extended VTEtreatment in the general population, high-risk subgroups, and patients with clinical equipoise regardingthe continuation of anticoagulation.We conducted a meta-analysis of randomized controlled trials (RCTs) evaluating reduced dose apixaban(2.5 mg twice daily) or rivaroxaban (10 mg once daily), compared to their respective standard dose (5 mgtwice daily for apixaban, 20 mg once daily for rivaroxaban) for the extended treatment of venousthromboembolism (VTE). Reduced-dose DOACs appear to preserve efficacy while significantly lowering bleeding risk compared tostandard-dose regimens for extended VTE treatment. These benefits were consistent across studiedclinical subgroups, although a possible sex-based interaction was observed for VTE recurrence. Thesefindings support the use of reduced-dose DOACs as a safer alternative for extended anticoagulation andhighlight..."

Retrospective data • Review • Cardiovascular • Hematological Disorders • Respiratory Diseases • Venous Thromboembolism

Comparative effectiveness and safety of apixaban vs. rivaroxaban in patients with cirrhosis and portal vein thrombosis: An analysis of real-world data (ASH 2025) - "Anticoagulation is recommended to treat PVT despite low-certaintyevidence, largely derived from studies of heparin and warfarin. In this real-world cohort of patients with cirrhosis and PVT, apixaban and rivaroxaban were associatedwith similar effectiveness. Use of apixaban was associated with a lower incidence of bleeding thanrivaroxaban, although the CI included the null value of one. These findings are consistent with itsfavorable pharmacokinetic profile in hepatic impairment and with observations in other populations."

Clinical • HEOR • Real-world • Real-world evidence • Atrial Fibrillation • Biliary Cancer • Cardiovascular • Cerebral Hemorrhage • Chronic Kidney Disease • CNS Disorders • Fibrosis • Gastrointestinal Disorder • Hepatology • Immunology • Liver Cirrhosis • Liver Failure • Nephrology • Renal Disease • Thrombosis • Venous Thromboembolism

Pharmacometric analyses supporting apixaban doses in neonates with venous thromboembolism (ASH 2025) - P2, P3, P4 | "US PrescribingInformation. Bristol Myers Squibb, 2025) pediatric dosing strategy in neonates.Study supportStudy and professional writing support were funded by Pfizer/Bristol Myers Squibb."

Cardiovascular • Venous Thromboembolism

Risk of bleeding in chronic lymphocytic leukemia patients in remission treated with covalent Bruton tyrosine kinase inhibitors and contemporary anticoagulant or antiplatelet drugs: Real-world data analysis (ASH 2025) - "The study population was divided into two main cohorts: 1) Cohort 1: CLLpatients in remission treated with covalent BTKi (ibrutinib/acalabrutinib/zanubrutinib) concurrentlytreated with AC (rivaroxaban/apixaban/edoxaban/dabigatran) or AP agents (acetylsalicylicacid/clopidogrel/prasugrel/ticagrelor/ticlopidin), and 2) Cohort 2: CLL patients in remission treated withcovalent BTKi (ibrutinib/acalabrutinib/zanubrutinib) not concurrently treated with AC or AP agents.Cohort 1 was further subdivided into two groups: those treated only with AC and those treated only withAP. CLL patients in remission treated with covalent BTKis experience a significant risk ofbleeding events. This risk is substantially elevated when covalent BTKis therapy is combined with eitheranticoagulant or antiplatelet agents. Notably, our findings indicate no discernible difference in bleedingrisk between AC or AP agents when used concurrently with covalent BTKis."

Clinical • Real-world • Real-world evidence • Chronic Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia

primary prophylaxis with direct oral anticoagulants (DOACs) for transwomen taking estrogen is not cost-effective (ASH 2025) - "TW without a personal history of VTE were assumed to start DOAC prophylaxis (i.e.apixaban 2.5mg BID or rivaroxaban 10mg daily) with oral GAHT (i.e. 2mg daily of oral estradiol). At known TW-specific VTE rates and current DOAC pricing, DOAC prophylaxis is not a cost-effective strategy for adult TW patients receiving GAHT."

Cost effectiveness • HEOR • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Venous Thromboembolism

Association between increased Patients' out-of-pocket costs for apixaban and oral anticoagulant discontinuation in high-risk patients with atrial fibrillation - a retrospective Medicare claims study (ASH 2025) - "In these high-risk Medicare beneficiaries with AF, patients' OOPC nearly doubled following the shift ofapixaban to a higher formulary tier. More than one in four of these patients subsequently discontinuedtreatment. Higher OOPC were significantly associated with an increased likelihood of treatmentdiscontinuation."

Medicare • Reimbursement • Retrospective data • US reimbursement • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension

Outcomes and resource utilization during and after oral anticoagulant-related bleeding in chronic kidney disease (ORACLE-CKD): A population-based cohort study (ASH 2025) - "We accrued patients ≥66 years who were hospitalized for bleedingand had an OAC (apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin) dispensed precedingadmission (April 2012 to March 2022). Patients hospitalized with OAC-related bleeding are at high risk of death during andimmediately following hospitalization. Mortality risk was greater among patients with CKD. Within 1 yearof hospital discharge, three-quarters of patients with moderate or severe CKD visited the ED, and overhalf were readmitted to hospital."

Clinical • HEOR • Alzheimer's Disease • Atrial Fibrillation • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Dementia • Gastroenterology • Heart Failure • Ischemic stroke • Myocardial Infarction • Nephrology • Renal Disease • Respiratory Diseases • Venous Thromboembolism

Apixaban pharmacokinetics in newly diagnosed multiple myeloma patients treated in the benefit and isasocut clinical trials: The apixabor/mibapix study (ASH 2025) - "Bortezomib (V) is classified as aCYP3A4 inhibitor, while dexamethasone (DXM) is classified as P-gp and CYP3A4 inducers (Sorigue 2020).So, we sought to study the DDI interaction between apixaban and the NDMM SOC regimens.We present a study assessing (1) the apixaban concentration-time profile in NDMM receiving low dose d-containing regimens, (2) whether the addition of bortezomib increases apixaban concentration, (3) thethrombosis and bleeding rates within 6 months after the start of treatment.MethodsThis study was ancillary to the phase 3 randomized 2 arms BENEFIT (Isatuximab +VRd and IsaRd) andphase 2 single arm ISASOCUT (Isa 1400mg SC OBI +VRd) studies for transplant ineligible (TI) NDMMpatients and was offered to patients receiving apixaban for thromboprophylaxis per protocol twice daily.V was administered weekly (1.3 mg/m² SC) for the first 12 months, then days 1 and 15 up to month 18 inBENEFIT, while V was administered biweekly in cycle 1, and weekly thereafter..."

Clinical • PK/PD data • Cardiovascular • Hematological Disorders • Hematological Malignancies • Multiple Myeloma • Thrombosis

Impact of concurrent antiplatelet/NSAID use on the safety and efficacy of thromboprophylaxis with apixaban in patients with cancer: A post-hoc analysis of the AVERT trial (ASH 2025) - "The use of antiplatelet agents or NSAIDs in cancer patients receiving apixaban thromboprophylaxis isassociated with a significantly increased risk of clinically relevant bleeding and CRNMB, with no reductionin VTE risk. These findings highlight the need to re-evaluate the indication for antiplatelet agent andNSAID use, and to conduct an individualized bleeding risk assessment prior to the initiation ofthromboprophylaxis in cancer patients."

Clinical • Retrospective data • Oncology • Venous Thromboembolism