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For selected patients with venous thromboembolism (VTE), long-term anticoagulation can prevent recurrence — but the tradeoff is ongoing risk for bleeding. Three randomized trials published in 2025 will help us maximize benefit and minimize harm for these patients.
In a randomized trial that involved 2800 patients with unprovoked VTE or VTE with a persistent predisposing condition, researchers examined the effectiveness of reduced-dose anticoagulation for extended prophylaxis. Patients initially received at least 6 months of full-dose anticoagulation and then continued with either full doses (5-mg apixaban twice daily or 20-mg rivaroxaban once daily, per physician preference) or half those doses. The estimated 5-year incidence of recurrent VT…