Archive for the ‘Prophylaxis’ Category
Stephan Moll, MD writes… Today, June 23, 2017, the FDA approved a 5th new oral blood thinner for clinical use, Bevyxxa® (= Betrixaban), taken once daily. It is FDA approved to prevent blood clots (DVT and PE) for patients who are significantly immobile and, therefore, at increased risk for blood clots during and after hospitalization for an acute medical illness. Full prescribing information: here. FDA details: here.
In the study that led to FDA approval (APEX study; reference 1), Bevyxxa® was given for 5-6 weeks during and after hospitalization to patients with acute medical illnesses (heart failure, respiratory failure, infectious disease, rheumatic disease, or stroke) who had reduced mobility. Fewer blood clots happened in the patients treated with the drug, without an increase in major bleeding.
Consequences for my Practice
Bevyxxa® has not been studied in patients who have a DVT or PE and should not be used in such patients. However, it can be considered for 5-6 weeks for significantly immobile patients who are at high risk for a blood clot during and after a hospital admission for a severe acute medical illness.
- Cohen AT et al. Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients. APEX Investigators. N Engl J Med. 2016 Aug 11;375(6):534-44.
Disclosure: Dr. Moll has consulted for Portola, Janssen, and Boehringer-Ingelheim.
Last updated: June 25th, 2017