Older adults recovering from serious blood clots may benefit from the use of apixaban, according to an April 27 study published in the American Journal of Hematology. The research analyzed Medicare claims data for patients treated with oral anticoagulants following venous thromboembolism and found that those receiving apixaban experienced fewer major complications and spent more days at home compared to those on warfarin.
Venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, is a significant health concern among older adults. It often leads to hospitalization or rehabilitation due to a high risk of recurrence and associated complications. Long-term anticoagulant therapy is commonly prescribed to reduce this risk.
The study titled "Comparative Effectiveness of Oral Anticoagulants and Home Time After Venous Thromboembolism in Frail and Non-Frail Older Adults" examined data from over 18,000 Medicare beneficiaries between 2015 and 2019. Researchers found that apixaban was linked with a lower combined risk of recurrent blood clots or death within one year as well as reduced rates of major bleeding when compared with warfarin. Patients taking apixaban also had fewer days lost to hospital stays or care facilities—a measure known as "home time loss." In contrast, rivaroxaban did not show clear advantages over warfarin for preventing complications and was associated with greater loss of time at home than apixaban.
The research team led by members from the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife highlighted that these benefits were observed in both frail and non-frail older adults but were most pronounced among non-frail patients. The study's approach included separate analyses for frail individuals—who are typically underrepresented in clinical trials—to provide evidence relevant for real-world treatment decisions.
Researchers say their findings add important evidence for clinicians choosing among available anticoagulant therapies, especially when treatment goals include maintaining independence or minimizing institutional care. The authors include Sandra Shi, MD, MPH; Xiecheng Chen, PhD; Anna L. Parks, MD; Dae Hyun Kim, MD, MPH, ScD; along with others involved in the project.
