title: Apixaban Reduces Hospitalizations in Patients With Venous Thromboembolism: An Analysis of the Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-Line Therapy (AMPLIFY) Trial.
abstract: BACKGROUND
  In the Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-Line Therapy (AMPLIFY) trial, apixaban was noninferior to enoxaparin/warfarin in preventing recurrent symptomatic venous thromboembolism (VTE) or venous thromboembolism-related death, with significantly less bleeding. This analysis evaluated the effects of apixaban versus enoxaparin/warfarin on all-cause hospitalizations during AMPLIFY.
  
  
  RESULTS
  Of the 5365 patients included, 2676 received apixaban and 2689 received enoxaparin/warfarin. All-cause hospitalizations during the treatment period after the index event were captured using dedicated case report forms. Outcomes included all-cause hospitalizations and time from randomization to first hospitalization. Patients were censored at death, loss to follow-up, or end of study, whichever came first. Treatment effects were assessed using Cox proportional hazards regression models. During the treatment period after the index event, 343 patients were hospitalized at least once: 153 (5.72%) in the apixaban group and 190 (7.07%) in the enoxaparin/warfarin group. Compared with enoxaparin/warfarin, apixaban significantly reduced all-cause hospitalizations (hazard ratio 0.804, 95% CI=0.650-0.995, P=0.045). All-cause hospitalization rates within the first 30 days after the index event were 2.28% and 3.35% in the apixaban and enoxaparin/warfarin groups, respectively (hazard ratio 0.676, 95% CI=0.488-0.935, P=0.018). For all patients, the average per-patient estimated mean length of hospital stay was also shorter with apixaban than enoxaparin/warfarin (0.57 days versus 1.01 days, P<0.0001).
  
  
  CONCLUSIONS
  Apixaban significantly reduced all-cause hospitalizations versus enoxaparin/warfarin, and shortened the length of hospital stay in patients with acute venous thromboembolism.
  
  
  BACKGROUND
  URL: https://Clinicaltrials.Gov/. Unique identifier: NCT00643201.
authors.affiliation: Pfizer Inc, New York, NY (X.L.) University of Tennessee College of Pharmacy, Memphis, TN (X.L.).
authors.forename: Xianchen
authors.initials: X
authors.lastname: Liu
authors.affiliation: Pfizer Inc, Groton, CT (M.J., J.M., J.T.).
authors.forename: Margot
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Pfizer Inc, Groton, CT (M.J., J.M., J.T.).
authors.forename: Jack
authors.initials: J
authors.lastname: Mardekian
authors.affiliation: Bristol-Myers Squibb Inc, Princeton, NJ (H.P.).
authors.forename: Hemant
authors.initials: H
authors.lastname: Phatak
authors.affiliation: Pfizer Inc, Groton, CT (M.J., J.M., J.T.).
authors.forename: John
authors.initials: J
authors.lastname: Thompson
authors.affiliation: Guy's and St Thomas' Hospitals, London, UK (A.T.C.).
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Cohen
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D017984:Enoxaparin / Q000008:administration & dosage / Q000627:therapeutic use; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011655:Pulmonary Embolism / Q000188:drug therapy*; D011720:Pyrazoles / Q000627:therapeutic use*; D011728:Pyridones / Q000627:therapeutic use*; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000188:drug therapy*; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D014859:Warfarin
keywords: anticoagulants; hemorrhage; mortality; prevention; thrombosis