Expert Point of View: Agnes Y. Lee, MD

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Press conferencemoderator Agnes Y. Lee, MD, Medical Director of the Thrombosis Program and Associate Professor of Medicine at the University of British Columbia and Vancouver Coastal Health in Canada, said that apixaban is the third in a new line of anticoagulants for long-term prevention of thrombotic events.

“This is an important trial showing that apixaban is highly effective and safe for long-term treatment of venous thromboembolism. By contrast with dabigatran [Pradaxa] and rivaroxaban [Xarelto], the other two Xa inhibitors, apixaban therapy is minimally dependent (< 20%) on renal clearance. This gives us another therapeutic option and it is suitable for patients with moderate renal impairment,” Dr. Lee continued.

“More options are better so we can personalize therapy for our patients. This study shows how we can improve patient outcomes by conducting rigorous randomized trials,” she said.

Nevertheless, it’s important to point out that the study included only 42 patients with cancer, Dr. Lee told The ASCO Post. “The results might not apply to patients with cancer, who have a higher risk of treatment failure with anticoagulants than patients without cancer. Also, there are chemotherapeutic agents that do interact with this drug’s clearance mechanisms, raising a concern that therapeutic drug levels might not be achieved if patients are receiving certain chemotherapeutic drugs.” ■

Disclosure: Dr. Lee reported no potential conflicts of interest.

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