AVERT (subgroup analysis)
Trial question
What is the effect of apixaban in patients with cancer and a central venous catheter?
Study design
Multi-center
Double blinded
RCT
Population
217 patients
Inclusion criteria: patients with cancer-initiating chemotherapy who were at intermediate-to-high risk of VTE
Key exclusion criteria: lesions or conditions leading to increased risk of clinically significant bleeding; liver insufficiency; planned stem cell transplant; life expectancy < 6 months
Interventions
N=126 apixaban (a dose of 2.5 mg BID for 6 months)
N=91 placebo (matching placebo for 6 months)
Primary outcome
Venous thromboembolism at 180 days
4.8
18.7
18.7 %
14.0 %
9.3 %
4.7 %
0.0 %
Apixaban
Placebo
Significant decrease ▼
NNT = 7
Significant decrease in VTE at 180 days (4.8% vs. 18.7%; HR 0.26, 95% CI 0.14 to 0.47)
Secondary outcomes
Significant decrease in proximal DVT at 180 days (3.2% vs. 12.4%; HR 0.26, 95% CI 0.12 to 0.55)
Significant decrease in death at 180 days (0.8% vs. 2.2%; HR 0.35, 95% CI 0.24 to 0.49)
Safety outcomes
No significant differences in major bleeding, clinically relevant non-major bleeding.
Conclusion
In patients with cancer-initiating chemotherapy who were at intermediate-to-high risk of VTE, apixaban was superior to placebo with respect to VTE at 180 days.
Reference
Willem Brandt, Cameron Brown, Tzu-Fei Wang et al. Efficacy and safety of apixaban for primary prevention of thromboembolism in patients with cancer and a central venous catheter: A subgroup analysis of the AVERT Trial. Thromb Res. 2022 May 29;216:8-10.
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