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Cited by 852

The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.

Apixaban to Prevent Venous Thromboembolism in Patients with Cancer

Open access
Carrier, Marc, Abou-Nassar, Karim, Mallick, Ranjeeta, Tagalakis, Vicky, Shivakumar, Sudeep, Schattner, Ariah, Kuruvilla, Philip, Hill, Danny, Spadafora, Silvana, Marquis, Katerine, Trinkaus, Mateya, Tomiak, Anna, Lee, Agnes Y.Y., Gross, Peter L., Lazo-Langner, Alejandro, El-Maraghi, Robert, Goss, Glenwood, Le Gal, Gregoire, Stewart, David, Ramsay, Timothy, Rodger, Marc, Witham, Debra, Wells, Philip S.·2019·New England Journal of Medicine

Abstract

BACKGROUND: Patients with active cancer have an increased risk of venous thromboembolism, which results in substantial morbidity, mortality, and health care expenditures. The Khorana score (range, 0 to 6, with higher scores indicating a higher risk of venous thromboembolism) has been validated to identify patients with cancer at elevated risk for this complication and may help select those who could benefit from thromboprophylaxis. METHODS: We conducted a randomized, placebo-controlled, double-blind clinical trial assessing the efficacy and safety of apixaban (2.5 mg twice daily) for thromboprophylaxis in ambulatory patients with cancer who were at intermediate-to-high risk for venous thromboembolism (Khorana score, ≥2) and were initiating chemotherapy. The primary efficacy outcome was objectively documented venous thromboembolism over a follow-up period of 180 days. The main safety outcome was a major bleeding episode. RESULTS: Of the 574 patients who underwent randomization, 563 were included in the modified intention-to-treat analysis. Venous thromboembolism occurred in 12 of 288 patients (4.2%) in the apixaban group and in 28 of 275 patients (10.2%) in the placebo group (hazard ratio, 0.41; 95% confidence interval [CI], 0.26 to 0.65; P<0.001). In the modified intention-to-treat analysis, major bleeding occurred in 10 patients (3.5%) in the apixaban group and in 5 patients (1.8%) in the placebo group (hazard ratio, 2.00; 95% CI, 1.01 to 3.95; P = 0.046). During the treatment period, major bleeding occurred in 6 patients (2.1%) in the apixaban group and in 3 patients (1.1%) in the placebo group (hazard ratio, 1.89; 95% CI, 0.39 to 9.24). CONCLUSIONS: Apixaban therapy resulted in a significantly lower rate of venous thromboembolism than did placebo among intermediate-to-high-risk ambulatory patients with cancer who were starting chemotherapy. The rate of major bleeding episodes was higher with apixaban than with placebo. (Funded by the Canadian Institutes of Health Research and Bristol-Myers Squibb-Pfizer Alliance; AVERT ClinicalTrials.gov number, NCT02048865.).

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Metadata

Authors
Carrier, M., Abou-Nassar, K., Mallick, R., Tagalakis, V., Shivakumar, S., Schattner, A., Kuruvilla, P., Hill, D., Spadafora, S., Marquis, K., Trinkaus, M., Tomiak, A., Lee, A. Y. Y., Gross, P. L., Lazo-Langner, A., El-Maraghi, R., Goss, G., Le Gal, G., Stewart, D., Ramsay, T., Rodger, M., Witham, D., & Wells, P. S.
Venue
New England Journal of Medicine
Published
2019-02-21
Volume
380
Issue
8
Pages
711-719
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2902078827
Cited by
852
References
20
FWCI
85.65
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Apixaban to Prevent Venous Thromboembolism in Patients with Cancer. https://app.cochat.ai/papers/10.1056/nejmoa1814468
The paper
Carrier, M., Abou-Nassar, K., Mallick, R., Tagalakis, V., Shivakumar, S., Schattner, A., Kuruvilla, P., Hill, D., Spadafora, S., Marquis, K., Trinkaus, M., Tomiak, A., Lee, A. Y. Y., Gross, P. L., Lazo-Langner, A., El-Maraghi, R., Goss, G., Le Gal, G., Stewart, D., . . . Wells, P. S. (2019). Apixaban to Prevent Venous Thromboembolism in Patients with Cancer. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1814468

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.