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A trial directly comparing two commonly used blood-thinning drugs found that one carries a lower risk of dangerous bleeding in patients with clots in veins deep in the body, researchers reported in the New England Journal of Medicine.
The two drugs were: Eliquis, known chemically as apixaban and sold by Bristol Myers Squibb and Pfizer, and Xarelto (rivaroxaban) sold by Bayer and Johnson & Johnson.
The drugs, given to prevent recurrent blood clots that can lead to strokes, can sometimes also cause serious bleeding episodes. Through the trial, researchers found that Eliquis had a lower risk of bleeding.
“This trial provides highly anticipated evidence for physicians and should bring real peace of mind to venous thrombosis patients, who often live with the dual fear of blood clot recurrence and bleeding,” study leader Dr. Lana Castellucci of the Ottawa Hospital said in a statement.
The researchers enrolled 2,760 patients with a venous thrombosis — blood clots in the veins — in the legs or lungs and randomly assigned them to treatment with one of the two anticoagulants.
After three months, the standard course of treatment, 7.1 per cent of participants taking Xarelto had experienced clinically relevant bleeding, compared to 3.3 per cent of participants who received Eliquis.
There did not appear to be a difference in the risk of recurrent blood clots, suggesting both drugs work for their intended purpose, although there weren’t enough study participants to allow reliable detection of a true effect, researchers said.
The study involved mainly white patients with healthy kidneys and livers and without cancer or obesity, so the results may not be applicable to everyone, the researchers acknowledged.
“Despite these limitations, the trial provides vital evidence for the treatment of venous thromboembolism,” Dr. Lisa Moores of the Uniformed Services University of the Health Sciences in Bethesda, Ma., wrote in an editorial.
“Apixaban is a safer first-line option than rivaroxaban for minimizing the risk of bleeding without compromising the prevention of recurrent thrombosis.”
