Comparison of bleeding risk between rivaroxaban and apixaban in acute venous thromboembolism

Lana Castellucci, M.D.
University of Ottawa, Ottawa Hospital
Ottawa, ON, Canada

Rivaroxaban and apixaban are widely used to treat acute venous thromboembolism (VTE), but their comparative bleeding risk has remained uncertain due to the absence of direct randomized trials. In this presentation, Lana Castellucci presents findings from the COBRRA trial, a randomized, prospective study that compared clinically relevant bleeding events in patients treated with either rivaroxaban or apixaban. Over 2,700 patients with symptomatic pulmonary embolism or proximal deep vein thrombosis were randomized. Apixaban was associated with significantly fewer bleeding events than rivaroxaban over three months of treatment. No differences were observed in recurrent thrombosis or death.