No Benefit from Routine Thromboprophylaxis with Apixaban After Hospitalization for COVID-19

In patients discharged after COVID-19 hospitalization, low-intensity apixaban did not reduce the rate of COVID-19–associated thrombosis compared with placebo.

Microvascular and macrovascular thrombosis are major complications of COVID-19, and clinical trials have tested the utility of various antithrombotic strategies to improve outcomes. Although some studies suggest a durable elevated risk for thrombotic events in patients discharged after hospitalization for COVID-19, the utility of prophylactic anticoagulation in these patients is unknown.

In this multicenter trial (NCT04650087), investigators randomized 1217 adult patients being discharged after hospitalization for COVID-19 to receive apixaban 2.5 mg twice daily or placebo for 30 days. (Note: apixaban is not approved for this indication.) Patient enrollment was terminated early due to lower-than-expected event rates and declining incidence of…

Reviewing Author

Behnood Bikdeli, MD, MS

Disclosures

Grant/Research SupportBrigham and Women’s Hospital; American Heart Association and VIVA Physicians

Editorial BoardsThrombosis Research; Thrombosis and Haemostasis; Journal of the American College of Cardiology

Leadership Positions in Professional SocietiesSociety for Vascular Medicine (Research, Quality, and Publications Committee member); International Society on Thrombosis and Haemostasis

Behnood Bikdeli, MD, MS

Disclosures

Grant/Research SupportBrigham and Women’s Hospital; American Heart Association and VIVA Physicians

Editorial BoardsThrombosis Research; Thrombosis and Haemostasis; Journal of the American College of Cardiology

Leadership Positions in Professional SocietiesSociety for Vascular Medicine (Research, Quality, and Publications Committee member); International Society on Thrombosis and Haemostasis

No Benefit from Routine Thromboprophylaxis with Apixaban After Hospitalization for COVID-19

Topics

Reviewing Author