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Although most direct-acting oral anticoagulants (DOACs) cannot be used in patients with creatinine clearance lower than 30 mL/minute, apixaban is approved for use even in patients with end-stage renal disease (ESRD) based on its predominantly hepatic clearance. However, researchers have not conducted large-scale studies to evaluate the efficacy and safety of apixaban compared with warfarin for patients with ESRD and venous thromboembolism (VTE). In an industry-funded retrospective study, investigators used a national database (years, 2014–2018) and propensity score–adjusted analysis to compare outcomes among >11,500 patients with ESRD and newly diagnosed VTE who received either apixaban or warfarin.
Only 2% of patients received apixaban in 2…