apixaban / Generic mfg. - LARVOL DELTA

Apixaban and Spinal Anesthesia. (PubMed, A A Pract) - No abstract available

Journal • Anesthesia

Nephrotoxicity of direct factor Xa inhibitors: a pharmacovigilance study using real-world data from the Federal Adverse Event Reporting System database. (PubMed, Postgrad Med J) - "This study quantitatively analysed the relative risk of nephrotoxic adverse reactions associated with direct FXaIs, emphasizing the importance of renal function monitoring for these medications. The results indicate that Edoxaban has a significant association with nephrotoxicity, necessitating closer attention to its use and recommending additional renal function tests and drug concentration testing for high-risk patients."

Adverse events • Journal • Real-world evidence • Acute Kidney Injury • Renal Disease • Thrombosis

Reduced dose direct oral anticoagulants and time-in-therapeutic-range defined warfarin in new-onset atrial fibrillation: a report from the nationwide FinACAF study. (PubMed, Eur Heart J Open) - "Adjusted hazard ratios (HRs) for IS, intracranial haemorrhage (ICH), bleeding, and mortality were calculated for dabigatran (n = 2 672), rivaroxaban (n = 1 866), apixaban (n = 3 936), and warfarin (n = 43 548). DOACs with reduced doses are efficient and safe stroke prevention therapy in high-risk patients with AF when compared with warfarin therapy of sufficient TTR. In this comparison, warfarin therapy of excellent TTR-quality was associated with the lowest risk of bleeding and mortality."

Journal • Atrial Fibrillation • Cardiovascular • Cerebral Hemorrhage • Ischemic stroke • Nephrology • Renal Disease

ASPIRE-AF: Anticoagulation for Stroke Prevention In Patients With Recent Episodes of Perioperative AF After Noncardiac Surgery (clinicaltrials.gov) - P4 | N=2270 | Recruiting | Sponsor: Population Health Research Institute | Trial primary completion date: Dec 2026 ➔ Dec 2028

Trial primary completion date • Atrial Fibrillation • Cardiovascular

Oral Anticoagulation and Risk of Adverse Clinical Outcomes in Venous Thromboembolism. (PubMed, JAMA Intern Med) - "In this cohort study of patients with VTE who initiated an oral anticoagulant, apixaban was associated with a lower risk of VTE recurrence and major bleeding compared with rivaroxaban and warfarin. These results provide evidence to guide the selection of appropriate initial oral anticoagulant regimens for adult patients with VTE."

Adverse events • Clinical data • Journal • Cardiovascular • Chronic Kidney Disease • Nephrology • Oncology • Renal Disease • Venous Thromboembolism

Identifying Optimized Parameters to Enhance the Productivity of Gas Generating Pellets Using a Dome Type Extruder. (PubMed, Recent Adv Drug Deliv Formul) - "This study successfully optimized process parameters for pellet production using a dome-type extruder, employing a Quality by Design (QbD) approach. Key factors influencing pellet yield and quality-extrusion speed, spheronization speed, and spheronization time-were identified and systematically optimized. These optimized pellets may potentially undergo further coating with polymers to facilitate gastro-retentive or floating drug delivery systems, expanding their applicability in pharmaceutical formulations."

Journal

Synthetic data distillation enables the extraction of clinical information at scale. (PubMed, NPJ Digit Med) - "We evaluated performance across three tasks: synthetic clinical trial criteria, the i2b2 2018 Clinical Trial Eligibility Challenge, and apixaban trial criteria questions...Results from 3B- and 1B-parameter models showed a clear size-performance tradeoff. This work demonstrates synthetic data distillation's potential for enabling scalable clinical information extraction."

Journal

Intraoperative antithrombotic drug removal during heart transplantation: insights from the international safe and timely antithrombotic removal (STAR) registry (HEART FAILURE 2025) - "Results-A total of 7 patients were included (3 on ticagrelor, 2 on apixaban and 2 on dabigatran) from 3 centres in Germany and Belgium. Conclusion(s)-This analysis of the ongoing STAR registry shows that intraoperative hemoadsorption is a simple, safe and potentially effective solution to minimize serious perioperative bleeding in patients on AT undergoing heart transplantation. Prospective, controlled studies in larger cohorts are needed to validate the efficacy of this method."

Cardiovascular

Direct oral anticoagulants in patients with heart failure and atrial fibrillation: do we have an ideal score to predict major bleeding? (HEART FAILURE 2025) - " We scanned the archive of our hospital for pts initiated on dabigatran, rivaroxaban, apixaban or edoxaban from June 2014 to November 2023 in whom the option "congestive HF/left ventricular systolic dysfunction" had been selected by calculating the CHA2DS2VASc score. Currently, we still do not have scores that can adequately predict MB. Especially in HF pts, who are often comorbid, our assessment must necessarily be multi-parametric and individualised from patient to patient. Our experience shows that the use of the DOAC score and a frailty score may help in planning a more appropriate and possibly closer follow-up for HF pts."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Ischemic stroke • Thrombosis

Prescribing preferences for reduced-dose direct oral anticoagulation for extended-phase venous thromboembolism treatment. (PubMed, Thromb Res) - "Most clinicians elect to dose-reduce DOACs during the extended phase of anticoagulation. Provider type and number of patients correlated with prescribing practices. These findings identify opportunities to advance clinician education surrounding dose-reduction when clinically indicated."

Journal • Cardiovascular • Hematological Disorders • Venous Thromboembolism

SPLENIC LACERATION AND HEMORRHAGE FOLLOWING ROUTINE COLONOSCOPY IN A PATIENT ON ANTICOAGULATION THERPAY: A COMPLEX CASE MANAGEMENT (SSAT 2025) - "Apixaban was withheld, and Andexanet alfa was used for reversal. Small volume abdominal and pelvic hemoperitoneum.Fig 2: Splenic capsular injury/capsular rupture with mildly increased, large perisplenic hematoma and hemoperitoneum with now no evidence of current contrast extravasation. The lesion now can be classified as AAST grade III injury."

Clinical • Atrial Fibrillation • Breast Cancer • Cardiovascular • Hematological Disorders • Hypertension • Hypotension • Musculoskeletal Pain • Oncology • Pain • Solid Tumor

Anticoagulant prescribing trends, bleeding events, and reversal agent use in pediatric patients: A retrospective, real-world study. (PubMed, PLoS One) - "This retrospective real-world study aimed to describe anticoagulant prescribing trends, particularly for factor Xa (FXa) inhibitors, bleeding events, and reversal agent use in pediatric patients to assess potential populations for clinical trials of the FXa inhibitor reversal agent andexanet alfa. Real-world health care data from the TriNetX Global Network and Optum's deidentified Clinformatics® Data Mart Database (CDM) were analyzed to identify patients aged <18 years old who were prescribed a direct oral FXa inhibitor, warfarin, or low-molecular-weight heparins from 2007 through 2024 (TriNetX, N = 59,780) or 2023 (CDM, N = 6470)...Prescriptions of the FXa inhibitor rivaroxaban increased from 0.4% (2009) to 18.0% (2023) in TriNetX and from 0.8% (2011) to 34.0% (2023) in CDM, with similar trends for apixaban...Direct oral FXa inhibitor use in children is growing, as is the potential for associated bleeds; however, reversal agent use is rare in this..."

Journal • Real-world evidence • Retrospective data • Pediatrics

TIME-SPECIFIC RISK OF THROMBOEMBOLIC AND GI BLEEDING EVENTS FOLLOWING REINITIATION OF DIRECT ORAL ANTICOAGULANTS AFTER ELECTIVE COLONOSCOPY (DDW 2025) - "METHODS : We retrospectively identified 7,589 Kaiser Permanente Northern California (KPNC) members 18 years and older who underwent an outpatient colonoscopy with an active DOAC prescription (dabigatran, rivaroxaban or apixaban) between January 1, 2016 and December 31, 2022 and had electronically documented instructions regarding the timing of DOAC reinitiation. There was no difference in GIB risk based on DOAC reinitiation timing. These findings suggest that although the frequency of TE and GIB events are low regardless of the timing of DOAC reinitiation post-colonoscopy, TE risk may warrant more consideration than GIB risk."

Cardiovascular • Gastrointestinal Disorder

OPERATION CLOT BE GONE: A SUCTION AND EXTRACTION-FUELED QUEST TO UNMASK THE SOURCE OF A SNEAKY BLEED (DDW 2025) - "Several endoscopic tools, including prokinetic agents (e.g., erythromycin and metoclopramide) and suction caps (e.g., distal caps), can manage clot burden, though their effectiveness varies...Case Presentation A 43-year-old female with DVT on Apixaban, AICD for ventricular tachycardia and long-QT syndrome, presented for acute-on-chronic alcohol-related pancreatitis...Our practice and other practices have also used it for management of food boluses, however never as clot removal contraptions. This case highlights the successful removal of the clot, revealing the ulcerated pseudoaneurysm, but also the tantamount degree of adapting and combining treatment strategies on-the-spot to manage complex situations."

Cardiovascular • Hematological Disorders • Pancreatitis • Peptic Ulcer • Ventricular Tachycardia

IS EVERYONE ON ELIQUIS??! ANTIPLATELETS/ANTICOAGULANTS IN THE INPATIENT SETTING (DDW 2025) - No abstract available

Clinical

SPLENIC LACERATION AND HEMORRHAGE FOLLOWING ROUTINE COLONOSCOPY IN A PATIENT ON ANTICOAGULATION THERPAY: A COMPLEX CASE MANAGEMENT (DDW 2025) - "Apixaban was withheld, and Andexanet alfa was used for reversal. This case underscores the importance of early recognition and multidisciplinary management of splenic injuries in patients on anticoagulation therapy. Splenic artery embolization can be life saving and should be considered in severe injuries to preserve splenic function."

Clinical • Atrial Fibrillation • Breast Cancer • Cardiovascular • Hematological Disorders • Hypertension • Hypotension • Musculoskeletal Pain • Oncology • Pain • Solid Tumor

EFFECT OF ANTIPLATELET/ANTICOAGULATION THERAPY ON DETECTION RATES OF BENIGN AND MALIGNANT NEOPLASMS USING FECAL OCCULT BLOOD TEST (DDW 2025) - "The AP/AC group included patients who received antiplatelet (aspirin, clopidogrel) or anticoagulation therapy (apixaban, rivaroxaban, warfarin) within 7 days prior to testing. Our findings show that among patients with a positive FOBT, the use of antiplatelet/anticoagulation therapy is associated with a lower risk of detecting both benign and malignant neoplasms, suggesting that AP/AC therapy may reduce the positive predictive value (PPV) of FOBT. This reduction in PPV may indicate that the FOBT is less likely to correctly identify true lesions in patients on AP/AC therapy. Future studies should explore how specific AP/AC agents influence the test's performance and further evaluate the clinical significance of these findings in the context of gastrointestinal bleeding and lesion detection."

Colorectal Cancer • Gastroenterology • Gastrointestinal Disorder • Oncology

EFFECT OF ANTIPLATELET/ANTICOAGULATION THERAPY ON DETECTION RATES OF BENIGN AND MALIGNANT NEOPLASMS USING FECAL IMMUNOCHEMICAL TESTING (DDW 2025) - "The AP/AC group included patients who received antiplatelet (aspirin, clopidogrel) or anticoagulation therapy (apixaban, rivaroxaban, warfarin) within 7 days prior to testing. Our findings suggest that the use of antiplatelet and anticoagulation therapy does not significantly affect the detection rates of benign or malignant neoplasms in patients with positive FIT results. These results support the continuation of AP/AC therapy during FIT screening, as it does not appear to impact the performance of the test. Future studies should explore the role of specific AP/AC agents in the detection of neoplasms or investigate the impact of these therapies on other noninvasive screening methods, such as fecal-based DNA or blood-based DNA tests."

Colorectal Cancer • Gastroenterology • Gastrointestinal Disorder • Oncology • Solid Tumor

Prevention of Thromboembolism Using Apixaban vs Enoxaparin Following Spinal Cord Injury (clinicaltrials.gov) - P=N/A | N=60 | Recruiting | Sponsor: Loewenstein Hospital | Trial completion date: Feb 2025 ➔ Feb 2026 | Trial primary completion date: Aug 2024 ➔ Aug 2025

Trial completion date • Trial primary completion date • Cardiovascular • CNS Disorders • Musculoskeletal Diseases • Orthopedics

PAUSE 2 RCT: Perioperative Anticoagulant Use for Surgery Evaluation -2 (PAUSE-2) Study Patients Receiving a Direct Oral Anticoagulant (DOACs-Dabigatran, Rivaroxaban, Apixaban or Edoxaban) and Needing Elective High-Bleed-Risk Surgery or an Invasive Procedure (clinicaltrials.gov) - P=N/A | N=920 | Recruiting | Sponsor: McMaster University

New trial • Atrial Fibrillation • Cardiovascular

A rare source of ectopic ACTH secretion causing cyclical Cushing’s syndrome (ESPE-ESE 2025) - "She was commenced on block and replace therapy with metyrapone and dexamethasone, as well as apixaban for thromboprophylaxis. She underwent surgical resection with intraoperative ultrasound guidance of two tumours found in the ileum, as well as the pathological mesenteric lymph nodes identified on PET CT, with perioperative hydrocortisone and octreotide cover...Histopathology confirmed a grade 2 well- differentiated mid-gut NET expressing ACTH with nodal metastases. She remains under regular endocrine follow up and is awaiting a repeat Gallium-68 DOTATATE PET CT to guide further management."

Cardiovascular • CNS Disorders • Cushing’s Disease • Endocrine Cancer • Endocrine Disorders • Hypertension • Neuroendocrine Tumor • Oncology • Sleep Disorder • Solid Tumor

A Fatal Complication After Prophylactic Anticoagulation for COVID-19 in a Lung Transplant Recipient (ATS 2025) - "We describe a lung transplant recipient who developed RSH following prophylactic enoxaparin administration for COVID-19 treatment. Description: 78-year-old man with a significant medical history including bilateral lung transplantation two years prior due to chronic obstructive pulmonary disease (COPD), maintained on an immunosuppressive regimen of tacrolimus, mycophenolate mofetil, and prednisone presented to the emergency department with fever, severe headaches, and myalgias...He was initiated on a treatment regimen including high-dose steroids, remdesivir, monoclonal antibodies (casirivimab and imdevimab), and apixaban for thromboembolism prophylaxis...In the context of COVID-19, where anticoagulation is frequently indicated, awareness of RSH's potential is essential. While most RSH cases can be managed conservatively or via angiographic intervention, this case highlights the increased mortality risk associated with RSH in patients suffering from COVID-19."

Clinical • Cardiovascular • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Musculoskeletal Pain • Novel Coronavirus Disease • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Transplantation

A Copy Number Gain in NFKB2 in a Patient with Immune Dysregulation (CIS 2025) - "Regarding his prior history, he had been on eltrombopag, although required oral corticosteroids several times annually for ITP crises...He was treated with a prolonged course of antibiotics and a bivalirudin drip and transitioned to apixaban upon discharge...Parental testing is pending, and functional validation is being pursued. As genetic testing becomes standard of care, integrating CNV analysis into routine sequencing will aid in diagnosis and improve treatment options for patients."

Clinical • Cardiovascular • CNS Disorders • Dermatology • Hematological Disorders • Immune Thrombocytopenic Purpura • Immunology • Infectious Disease • Inflammation • Measles • Mumps • Otorhinolaryngology • Pancreatitis • Pneumococcal Infections • Tetanus • Thrombocytopenic Purpura • Thrombosis • Varicella Zoster • Vitiligo • NFKB2

ANTERIOR SUPRASCAPULAR NERVE BLOCK FOR REVISION TOTAL SHOULDER ARTHROPLASTY IN A PATIENT WITH SIGNIFICANT RESPIRATORY COMPROMISE (ASRA-SPRING 2025) - "CASE REPORTOur patient is a 66-year-old female with uncontrolled hypertension, COPD on 4L O2 prn nightly, current smoker (11.5 pack-years), history of pulmonary embolism s/p apixaban treatment, CVA with residual left-sided weakness, bipolar II disorder, and chronic pain taking tramadol, pregabalin, and oxycodone-acetaminophen...We connected standard ASA monitors, performed time-out, and premedicated with midazolam 2mg...We anesthetized the skin, advanced a 50mm needle near the suprascapular nerve under ultrasound guidance, deposited 10mL of 0.5% ropivacaine, and confirmed local anesthetic spread around the suprascapular nerve (Figure 1)...She was discharged on POD 4 without complication. We believe our decision to place an ASSB for I&D and revision total shoulder arthroplasty achieved our goal to provide safe and satisfactory anesthetic care to our medically complex patient."

Clinical • Anesthesia • Bipolar Disorder • Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Hypertension • Immunology • Infectious Disease • Musculoskeletal Pain • Orthopedics • Pain • Psychiatry • Pulmonary Embolism • Respiratory Diseases

A HIP OUTLOOK ON NEURAXIAL: A CASE REPORT EXAMINING A TOTAL HIP ARTHROPLASTY PERFORMED UNDER CONTINUOUS SPINAL ANESTHESIA (ASRA-SPRING 2025) - "Seven days later, surgery was attempted under general anesthesia after an interdisciplinary discussion determined inappropriately high risk of epidural hematoma with neuraxial given apixaban utilization the day before...For positioning, he received a pericapsular nerve group block with 20ml of 0.5% ropivacaine. A pre-induction arterial line was inserted and 0.2 mcg/kg/hr of dexmedetomidine started without bolus...Continuous spinal anesthesia was selected for its potential to allow for greater hemodynamic stability compared to single shot techniques and to avoid GA risks. Despite careful perioperative planning, poor outcomes can occur."

Case report • Clinical • Anemia • Anesthesia • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Coronary Artery Disease • Heart Failure • Hematological Disorders • Hypertension • Hypotension • Musculoskeletal Diseases • Nephrology • Orthopedics