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

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. methods and 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. © 2015 the authors.