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Article

Effectiveness and Safety of Apixaban vs. Warfarin in Venous Thromboembolism Patients with Obesity and Morbid Obesity

1
Department of Hematological Medicine, Guy’s & St Thomas’ NHS Foundation Trust, King’s College London, Westminster Bridge Road, London SE1 7EH, UK
2
STATinMED Research, Ann Arbor, MI 48108, USA
3
Pfizer Inc., New York, NY 10017, USA
4
Bristol Myers Squibb Company, Lawrenceville, NJ 08648, USA
5
New York City College of Technology, City University of New York, New York, NY 11201, USA
6
Pfizer Inc., Groton, CT 06340, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(2), 200; https://doi.org/10.3390/jcm10020200
Received: 13 November 2020 / Revised: 21 December 2020 / Accepted: 31 December 2020 / Published: 8 January 2021
(This article belongs to the Section Vascular Medicine)
This study integrated 5 United States healthcare claims databases to evaluate the risk of recurrent venous thromboembolism (VTE) and major bleeding (MB) among VTE patients who initiated apixaban vs. warfarin, stratified by obesity. Obese and morbidly obese patients were identified based on diagnosis codes. Stabilized inverse probability treatment weighting (IPTW) was conducted to balance observed patient characteristics between treatment cohorts. An interaction analysis was conducted to evaluate treatment effects of apixaban vs. warfarin according to obesity status. Cox proportional hazard models were used to evaluate the risk of recurrent VTE and MB among IPTW weighted obese and morbidly obese patients. A total of 112,024 non-obese patients and 43,095 obese patients were identified, of whom 19,751 were morbidly obese. When stratified by obesity status post-IPTW, no significant interactions were observed for effects of apixaban vs. warfarin on recurrent VTE or MB (interaction p > 0.10). Among IPTW obese and morbidly obese patients, apixaban was associated with a significantly lower risk of recurrent VTE (obese: 0.73 [0.64–0.84]; morbidly obese: 0.65 [0.53–0.80]) and MB (obese: 0.73 [0.62–0.85]; morbidly obese: 0.68 [0.54–0.86]) as compared with warfarin. In this large sample of obese and morbidly obese VTE patients, apixaban had a significantly lower risk of recurrent VTE and MB vs. warfarin. View Full-Text
Keywords: venous thromboembolism; direct oral anticoagulants; apixaban; warfarin; recurrent venous thromboembolism; major bleeding; obesity; morbidly obese venous thromboembolism; direct oral anticoagulants; apixaban; warfarin; recurrent venous thromboembolism; major bleeding; obesity; morbidly obese
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MDPI and ACS Style

Cohen, A.; Sah, J.; Lee, T.; Rosenblatt, L.; Hlavacek, P.; Emir, B.; Keshishian, A.; Yuce, H.; Luo, X. Effectiveness and Safety of Apixaban vs. Warfarin in Venous Thromboembolism Patients with Obesity and Morbid Obesity. J. Clin. Med. 2021, 10, 200. https://doi.org/10.3390/jcm10020200

AMA Style

Cohen A, Sah J, Lee T, Rosenblatt L, Hlavacek P, Emir B, Keshishian A, Yuce H, Luo X. Effectiveness and Safety of Apixaban vs. Warfarin in Venous Thromboembolism Patients with Obesity and Morbid Obesity. Journal of Clinical Medicine. 2021; 10(2):200. https://doi.org/10.3390/jcm10020200

Chicago/Turabian Style

Cohen, Alexander, Janvi Sah, Theodore Lee, Lisa Rosenblatt, Patrick Hlavacek, Birol Emir, Allison Keshishian, Huseyin Yuce, and Xuemei Luo. 2021. "Effectiveness and Safety of Apixaban vs. Warfarin in Venous Thromboembolism Patients with Obesity and Morbid Obesity" Journal of Clinical Medicine 10, no. 2: 200. https://doi.org/10.3390/jcm10020200

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