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Venous thrombosis in cancer patients is usually managed with daily subcutaneous injections of low-molecular-weight heparin (LMWH). To test the safety and efficacy of the new oral anticoagulant apixaban in this setting, investigators conducted an industry-supported, international, randomized, double-blind trial of patients with acute venous thromboembolism (VTE) treated with 6 months of either apixaban (10 mg twice daily for 1 week followed by 5 mg twice daily) or the LMWH enoxaparin (1 mg/kg twice daily for 5 days followed by dose-adjusted warfarin).
Among 513 patients with active cancer or a cancer history, the rate of recurrent VTE was lower with apixaban than with enoxaparin and warfarin (1.9% vs. 6.3%; relative risk, 0.30; 95% confidence…