2026 Eastern States Conference

Authors
Michael Duong, PharmD; Victoria Ireland, PharmD; Swana Thomas, PharmD, MPH; Erin McMahan; PharmD, BCPS
Objective
To compare recurrent venous thromboembolism (VTE) in patients with obesity receiving reduced-dose apixaban (2.5 mg twice daily) versus standard-dose apixaban (5 mg twice daily) during extended anticoagulation.
Methods
This retrospective cohort study includes obese adults (body mass index ≥ 30 kg/m2) with prior VTE receiving apixaban 2.5 mg or 5 mg twice daily for extended anticoagulation after completing at least 6 months of initial therapy. Data was obtained from the Geisinger Health System electronic health record from January 1, 2022 to December 31, 2024
The primary outcome is recurrent VTE during extended therapy. Secondary outcomes include time to recurrent VTE and major bleeding defined by International Society on Thrombosis and Hemostasis criteria.
Due to limitations in capturing outpatient dose transitions, the start of extended therapy was standardized as 6 months after the index VTE
Results
Results are pending at the time of submission.
Conclusion
This study will provide real-world data comparing reduced-dose and standard-dose apixaban for extended anticoagulation in patients with obesity with VTE and may help inform dosing decisions in this population.
Self-Assessment Question
In patients with obesity receiving extended anticoagulation for VTE, how do recurrent VTE and major bleeding outcomes differ between reduced-dose and standard-dose apixaban?