VTE

Question 1

AVERROES
n =
Comparators =
Publication and year =

Answer 1

n=5,599
Apixaban vs ASA for stroke prevention in NVAF
NEJM 2011

Question 2

AVERROES
Primary endpoints =
Takeaways =

Answer 2

Superiority trial
Primary endpoint = Stroke/SE
Takeaways
1. Stopped early due to 55% reduction in primary outcome with apixaban
2. No change in death rate but trended towards apixaban benefit
3. Major bleeding essentially same in each group (including 11 apixaban ICH vs 13 ASA)

Question 3

Name the major AVERROES post-hoc and its main takeaways

Answer 3

Eikelboom 2012 (Renal - Stage III CKD)

CKD III patients experienced same benefit in primary endpoint of reduced stroke/SE without increased bleeding

ARR was better for CKD III patients with apixaban compared with normal renal function

Question 4

AEGEAN

Purpose
Results

Answer 4

Assessed impact of formalized DOAC education on adherence/compliance

1. Educational booklet
2. Reminder tools (key ring, SMS texts, Smartphone App)
3. Access to “virtual clinic” using ATS staff

Results: NO DIFFERENCE BETWEEN GROUPS (essentially saying extra ed does not help with adherence)

Question 5

AEIOU

Purpose
Comparators
Results
n

Answer 5

Uninterrrupted vs minimally interrupted apixaban for ABLATION procedures

(Minimally interrupted - skipped dose morning of procedure)

Compared to a retrospective analysis of similarly matched warfarin patients

Results:
No difference between groups with stroke/SE
All 3 strategies are reasonable

n = 150 in each apixaban group; compared with n=295 in retrospective warfarin group

Question 6

Amin RWE analysis

Study population & year
Purpose
Ultimate conclusions

Answer 6

2017

Medicare claims

DOAC and warfarin costs

Retrospective propensity matching

ULTIMATE CONCLUSION: Apixaban lower all-cause health care costs as well as major bleeding-related medical costs

All endpoints favor apixaban tremendously VS WARFARIN

Apixaban vs dabigatran - All favor apixaban but mostly only in point estimates (CI cross 1)

Question 7

ARCADIA

Answer 7

Not yet finished
Apixaban 5 BID vs ASA 81/d for
SECONDARY stroke prevention
Age of at least 45; 1,000 patients planned (USA & Canada)

Question 8

AREST

Answer 8

Not yet finished
Apixaban vs warfarin SECONDARY prevention of stroke/TIA in AF

120 patients planned
180 days tx