Abstract | BACKGROUND: METHODS: RESULTS: The primary efficacy outcome occurred in 59 of 2609 patients (2.3%) in the apixaban group, as compared with 71 of 2635 (2.7%) in the conventional-therapy group (relative risk, 0.84; 95% confidence interval [CI], 0.60 to 1.18; difference in risk [ apixaban minus conventional therapy], -0.4 percentage points; 95% CI, -1.3 to 0.4). Apixaban was noninferior to conventional therapy (P<0.001) for predefined upper limits of the 95% confidence intervals for both relative risk (<1.80) and difference in risk (<3.5 percentage points). Major bleeding occurred in 0.6% of patients who received apixaban and in 1.8% of those who received conventional therapy (relative risk, 0.31; 95% CI, 0.17 to 0.55; P<0.001 for superiority). The composite outcome of major bleeding and clinically relevant nonmajor bleeding occurred in 4.3% of the patients in the apixaban group, as compared with 9.7% of those in the conventional-therapy group (relative risk, 0.44; 95% CI, 0.36 to 0.55; P<0.001). Rates of other adverse events were similar in the two groups. CONCLUSIONS: A fixed-dose regimen of apixaban alone was noninferior to conventional therapy for the treatment of acute venous thromboembolism and was associated with significantly less bleeding (Funded by Pfizer and Bristol-Myers Squibb; ClinicalTrials.gov number, NCT00643201).
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Authors | Giancarlo Agnelli, Harry R Buller, Alexander Cohen, Madelyn Curto, Alexander S Gallus, Margot Johnson, Urszula Masiukiewicz, Raphael Pak, John Thompson, Gary E Raskob, Jeffrey I Weitz, AMPLIFY Investigators |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 369
Issue 9
Pg. 799-808
(Aug 29 2013)
ISSN: 1533-4406 [Electronic] United States |
PMID | 23808982
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anticoagulants
- Enoxaparin
- Factor Xa Inhibitors
- Pyrazoles
- Pyridones
- apixaban
- Warfarin
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Topics |
- Acute Disease
- Administration, Oral
- Adult
- Aged
- Anticoagulants
(administration & dosage, adverse effects, therapeutic use)
- Double-Blind Method
- Enoxaparin
(adverse effects, therapeutic use)
- Factor Xa Inhibitors
- Female
- Follow-Up Studies
- Hemorrhage
(chemically induced, mortality)
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Pyrazoles
(administration & dosage, adverse effects)
- Pyridones
(administration & dosage, adverse effects)
- Treatment Outcome
- Venous Thromboembolism
(drug therapy)
- Warfarin
(adverse effects, therapeutic use)
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