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Apixaban does not increase bleeding in patients with renal insufficiencies
Compared with conventional anticoagulants, use of apixaban resulted in a lower bleeding risk in patients with mild or moderate-to-severe renal impairment, according to results of a meta-analysis.
“Our systematic review and meta-analysis suggests that the use of apixaban is safe in patients with mild and moderate-to-severe renal impairment regardless of indications compared with conventional therapy,” Ranjan Pathak, MD, of the department of medicine, Reading Health System, Reading, Pa., and colleagues wrote. “Our study indicates that at currently used doses, apixaban does not have increased bleeding, even in patients with moderate-to-severe renal impairment.”
The researchers performed a meta-analysis and systematic review to assess this risk. The investigators included six randomized controlled trials involving 40,145 patients in their meta-analysis.
The results showed that apixaban (Eliquis, Bristol-Myers Squibb) had a statistically significant lower bleeding risk in patients with mild renal impairment compared with conventional anticoagulants (vitamin K antagonist, warfarin, aspirin, placebo) (RR = 0.80; 95% CI, 0.66-0.96, I2 = 13%), they wrote. The bleeding risk was similar in patients with moderate-to-severe renal insufficiency (RR = 1.01; 95% CI, 0.49-2.10, I2 = 72%).
The study did not examine severe renal impairment, which may have led to underestimation of bleeding risk in the moderate-to-severe renal impairment subgroup, the researchers wrote.
“In our study, we tried to include all the available randomized controlled trials on apixaban, thus increasing the number of study participants. This makes our data more robust and validates earlier findings [in similar studies],” they said.
Disclosure: The researchers report no relevant financial disclosures.