Hematology · 3 h ago
RENOVE Post Hoc Analysis Finds Similar Outcomes With Apixaban and Rivaroxaban
A non-randomised post hoc comparison within the RENOVE trial assessed extended anticoagulation in 2,768 patients with venous thromboembolism. Over a median 37 months, clinically relevant bleeding and recurrent VTE rates did not differ significantly between apixaban and rivaroxaban.
- Five-year clinically relevant bleeding incidence was 11.7% versus 13.7%.
- Adjusted bleeding hazard ratio was 0.90 (95% CI 0.70–1.17).
- Drug choice was not randomised in this post hoc comparison.
The open-label RENOVE trial compared full-dose with reduced-dose apixaban or rivaroxaban in patients who had completed at least six months of full-dose treatment for venous thromboembolism (VTE) and required extended anticoagulation. This post hoc analysis compared outcomes by drug; treatment choice itself was not randomised. It included 1,513 patients receiving rivaroxaban and 1,255 receiving apixaban, with a median follow-up of 37 months.
The five-year cumulative incidence of clinically relevant bleeding was 11.7% with rivaroxaban and 13.7% with apixaban. The adjusted hazard ratio was 0.90 (95% CI 0.70–1.17), and the inverse probability weighted estimate was 0.92 (95% CI 0.70–1.21). Major bleeding, recurrent VTE, the composite outcome, arterial thromboembolic events and all-cause death were also reported as similar between groups.
The findings do not establish equivalence: drug allocation was non-randomised and may have influenced outcomes. They provide comparative evidence for extended treatment but do not, on their own, support changing anticoagulant selection. The abstract reports no funding information, and the full text was unavailable in the supplied source.
In practice
For patients with VTE continuing anticoagulation beyond six months, this post hoc analysis found no statistically significant difference in clinically relevant bleeding or recurrent VTE between apixaban and rivaroxaban. The comparison included 2,768 patients and had a median 37-month follow-up, but drug selection was not randomised, so differences in patient characteristics or prescribing may have affected results. These findings are informative for comparative assessment but do not establish equivalence or justify changing treatment selection on their own.
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European Respiratory Journal: Comparative Safety and Efficacy of Apixaban and Rivaroxaban During Extended Anticoagulation for Venous Thromboembolism: A Non-randomised Post Hoc Comparison Within the RENOVE Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.