Delving into the Latest Updates on Apixaban with Synapse

The LVT DURATION (Optimal Duration of Anticoagulation for LV Thrombus) is a pilot study planned to assess the practicalities of conducting a randomised control trial (RCT) whilst establishing data around the ideal duration of anticoagulation in the treatment of LV thrombus. The main objectives of the study are:
* To assess the practicalities of conducting an RCT with regard to recruitment, retention, and outcome measurement.
* To identify the optimal length of anticoagulation in the treatment of LV Thrombus
After randomisation participants will:
* Continue their prescribed oral anticoagulant for the remainder of the trial
* Discontinue their prescribed oral anticoagulant for the remainder of the trial

Start Date01 Dec 2026

Sponsor / Collaborator

Queen Mary University of London

CTIS2024-515630-33-00

/ CompletedPhase 3IIT

A single dose of apixaban for the prevention of thrombotic events in the context of long-distance flights (DANCE FLIGHT)

Start Date30 Nov 2026

Sponsor / Collaborator-

NCT06953726

/ Not yet recruitingPhase 4IIT

CSP #2037T - Veterans Affairs Learning Health System Initiative to Assess Novel Screening vs. Usual Care and Treatment With Apixaban vs. Rivaroxaban in Veterans With Atrial Fibrillation (VALIANT-AF-T) Trial

* The trial will compare two anticoagulants ("blood thinners") that are currently used in the VA and are considered standard care to prevent strokes in patients with atrial fibrillation. The two most commonly-used anticoagulants will be compared: apixaban (Eliquis) and rivaroxaban (Xarelto). They are considered by many doctors to have similar benefits and risks, but no one knows for sure.
* The trial only enrolls patients with a diagnosis of atrial fibrillation ("A Fib").
* The investigators will measure, in about 10,000 VA patients nationally, whether the rates of stroke, major bleeding, or death differ between these two drugs.
* The trial will last about 7 years, but after the first prescription, all information will be collected from electronic medical records.

Start Date30 Mar 2026

Sponsor / Collaborator

VA Office of Research and Development

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100 Clinical Results associated with Apixaban

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100 Translational Medicine associated with Apixaban

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100 Patents (Medical) associated with Apixaban

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6,098

Literatures (Medical) associated with Apixaban

01 Dec 2026·JOURNAL OF MOLECULAR MEDICINE-JMM

Measuring Neural Factor X Pathway Activity in Rodent Glioma Cell Culture and Brain Slices

Article

Author: Schiller, Maya ; Shavit-Stein, Efrat ; Golderman, Valery ; Chapman, Joab ; Gofrit, Shany Guly

Coagulation factor X (FX) plays a significant role in neuroinflammation and is considered a promising target for therapeutic intervention. However, because activated FX (FXa) levels in neural tissues are expected to be significantly lower than in plasma, a more sensitive, direct, and specific method is required for accurate detection. To measure FXa activity with high sensitivity, we used a fluorogenic substrate in combination with a panel of specific inhibitors to prevent nonspecific protease activity that potentially cleaves the substrate, initially validated in human normal and FX-deficient plasma. This approach allowed selective quantification of FXa activity in neural samples. To further characterize the FX pathway, we applied a FXa inhibitor (apixaban), a FX activator (Russell's viper venom X, RVVX), and commercially available FX and FXa to mouse brain slices and to glioma cell lines derived from human, rat, and mouse. FXa activity significantly increased following RVVX application in human plasma and mouse brain and was inhibited in a calcium-dependent manner in human plasma. In the mouse brain, apixaban inhibited only the FXa activity secreted from the slice rather than the slice-associated activity. In glioma cell lines, RVVX application increased cell-bound FXa activity, which was not inhibited by apixaban, while the activity secreted into the medium was elevated and inhibited by apixaban. Exposure to lipopolysaccharide reduced RVVX-induced FXa activity while increasing the thrombin activity in glioma cell lines from mice and rats, respectively. We developed a specific method of measuring basal FXa activity and induced from FX by RVVX, in plasma and secreted from brain slices and astrocyte tumor cells. The results were obtained in tissue with defined experimental conditions, pharmacologically differentiated tools, and biological validation as assessed by thrombin activity measurement. FXa activity in neural tissue is tightly regulated and undetectable without an FX activator. KEY MESSAGES: We developed a sensitive method using fluorescence substrate to measure the fine changes in FXa activity in neural tissue. Brain slice associated FXa activity differs from secreted activity in its response to activators and inhibitors, suggesting the complexity of FXa activity regulation in neural tissue. Specific set of conditions is needed to detect FXa activity in neural tissue.

01 Mar 2026·Journal of Stroke & Cerebrovascular Diseases

Temporal trends in the use of direct oral anticoagulants prior to stroke admission

Article

Author: Dasgupta, Dibbya Pravas ; Menon, Bijoy K ; Zhou, Lily W ; Sutherland, Jason ; Shoamanesh, Ashkan

BACKGROUND AND AIMS:

This population-based cohort study measures temporal trends in direct oral anticoagulants (DOAC) use before hospital admission among intracranial haemorrhage (ICH) and acute ischemic stroke (AIS) hospitalizations.

METHODS:

Consecutive patients with ICH and AIS in British Columbia (B.C.), Canada between 2015 and 2023 were identified using ICD-10 diagnosis codes from Canada's Discharge Abstract Database. Linkages were made with outpatient prescriptions. We used Cox regression with cause-specific hazard models to explore differences in hospitalization outcomes by DOAC use adjusting for patient demographics and stroke treatment.

RESULTS:

562/5434 (10.3%) of ICH and 3002/35,666 (8.4%) AIS discharges had DOAC exposure prior to hospital admission. Apixaban was the most common DOAC (49.7%) followed by rivaroxaban (41.4%), dabigatran (8.2%) and edoxaban (0.7%). The proportion of patients on DOACs increased every year among ICH patients by 9% (IRR 1.09, 95% CI 1.05-1.13; from 6.3% to 12.0%) and AIS by 10% (IRR 1.10, 95% CI 1.08-1.12; from 5.1% to 10.1%). After adjustment for patient demographics, health authority location in BC, patient comorbidities, ambulance use and reperfusion treatment, ICH patients admitted on DOACs were more likely to die in hospital (HR 1.27, 95% CI 1.06-1.51) and be transferred to long term care (HR 1.36, 95% 1.04-1.76).

CONCLUSIONS:

The proportion of patients on DOACs at admission doubled between 2015 and 2023. Patients on DOACs were older, had more comorbidities. Patients with ICH on DOAC prior to admission were more likely to have died during their hospitalization or be discharged to long-term care.

01 Mar 2026·Exploratory research in clinical and social pharmacy

Evaluating patient acceptability of clinical pharmacist engagement following clinical decision support

Article

Author: Seagull, F Jacob ; Smith, Shawna N ; Dorsch, Michael P ; Lin, Ying-Jen ; Barnes, Geoffrey D ; Fabbri, Morris

Background:

While Direct Oral Anticoagulant (DOAC) medications like apixaban and rivaroxaban have overtaken warfarin as first-line therapy for atrial fibrillation (AF) and venous thromboembolism (VTE), 10-20% of DOAC prescriptions deviate from the United States Food and Drug Administration (FDA) evidence-based package label instructions. To improve prescribing, we implemented electronic health record (EHR) alerts that encourage collaboration between prescribers and anticoagulation clinic pharmacists.

Objective:

This study investigates patients' acceptance and perceptions of outreach from anticoagulation pharmacists with whom they may not have preexisting relationships.

Methods:

We administered a 10-item structured questionnaire to 30 patients (or caregivers as proxies) who had received DOAC dosing recommendations directly from pharmacists following an EHR-based prescribing alert. The first 20 participants also answered open-ended interview questions. Mean scores were calculated for structured acceptability questions on a 5-point Likert scale. Interview transcripts were analyzed to identify facilitators and barriers to acceptance of pharmacist involvement in DOAC management. We also assessed alignment between quantitative and qualitative data.

Results:

Overall, patients found direct pharmacist outreach acceptable (mean acceptability score: 4.3, SD 0.15). Facilitators included pharmacists' expertise, clear communication, and friendly demeanor. Barriers included a perceived limit to pharmacists' prescribing authority and the timing of the advice. Pharmacists may mitigate these barriers by emphasizing that patients' doctors endorse the dosing recommendations and offering to answer additional questions at the end of calls.

Conclusions:

Anticoagulation pharmacists' direct outreach to patients can be valuable for DOAC management and is generally well-accepted. Addressing role confusion could further facilitate their direct patient contact.

330

News (Medical) associated with Apixaban

04 Mar 2026

·www.drugs.com

Diltiazem Linked to Increased Risk for Bleeding Complications in A-Fib

WEDNESDAY, March 4, 2026 -- For patients with atrial fibrillation (AF) receiving apixaban or rivaroxaban , use of diltiazem versus metoprolol is associated with an increased risk for serious bleeding complications, according to a study published online Feb. 24 in the Annals of Internal Medicine . Ghadeer K. Dawwas, Ph.D., from the Vanderbilt University School of Medicine in Nashville, Tennessee, and colleagues compared the risk for bleeding among AF patients using apixaban or rivaroxaban in combination with diltiazem versus metoprolol. A total of 23,000 users of diltiazem and 23,000 users of metoprolol were included in the matched cohort of AF patients. The researchers found that diltiazem versus metoprolol was associated with a higher risk for bleeding events after propensity score matching (rate difference, 5.4 per 1,000 person-years). With high- versus low-dose diltiazem, the risk for bleeding increased (risk difference, 9.2 versus 2.6 for high- and low-dose, respectively). The estimated risk differences between diltiazem and metoprolol were 0.48 and 0.31 percentage points, respectively, at 12 and six months. "Our examination of diltiazem dosages indicated a dose-dependent relationship, with higher doses associated with more bleeding," the authors write. Abstract/Full Text (subscription or payment may be required)

Clinical Result

03 Mar 2026

·www.drugs.com

A-Fib Drug, Diltiazem, Could Interact With Blood Thinners, Increase Risk Of Dangerous Bleeding

TUESDAY, March 3, 2026 — People with abnormal heart rhythms could be at risk of dangerous bleeding from a serious combination of prescription medications, a new study says. Patients with atrial fibrillation (A-Fib) often are prescribed diltiazem to help control their heart rate, researchers said in the Annals of Internal Medicine . Because A-Fib also greatly increases a person’s risk of stroke, these patients also are prescribed blood thinners like apixaban or rivaroxaban , researchers said. But the combination of diltiazem with either of those blood thinners caused higher rate of serious bleeding events among a group of 23,000 patients, researchers found. “Although diltiazem remains an appropriate and effective option for heart rate control in selected patients, our results underscore that bleeding risk must be a central consideration in treatment decisions,” lead researcher Ghadeer Dawwas said in a news release. She’s an assistant professor of medicine and health policy at Vanderbilt University Medical Center in Nashville, Tennessee. Diltiazem is a calcium channel blocker, which helps slow heart rate in people with A-Fib and weaken the heart’s contraction, according to the American Heart Association . However, diltiazem also inhibits the function of cytochrome enzymes, which are crucial for the metabolism of drugs. This might cause blood thinners to become more concentrated in the bloodstream, increasing the risk of dangerous bleeding, researchers said. For this study, researchers compared 23,000 A-Fib patients prescribed diltiazem against another 23,000 prescribed metoprolol , a beta blocker also used to slow the heart rate in these patients. These patients also had been prescribed either apixaban or rivaroxaban. The team tracked which drug combination caused a higher risk of dangerous bleeding in the brain, GI system or elsewhere in the body. Results showed 467 serious bleeding events among diltiazem users compared to 397 among those prescribed metoprolol. Overall, diltiazem was associated with an 18% increased risk of dangerous bleeding, the study found. Further, the risk grew with higher doses of diltiazem, researchers discovered. The bleeding risk “is especially relevant for patients receiving higher doses exceeding 120 mg/day of diltiazem or those taking additional interacting medications,” Dawwas said. “In such cases, metoprolol may represent a safer alternative.” Sources Vanderbilt University, news release, Feb. 26, 2026

AHADrug ApprovalClinical Study

03 Mar 2026

·www.drugs.com

A-Fib Drug Could Interact With Blood Thinners, Increase Risk Of Dangerous Bleeding

TUESDAY, March 3, 2026 — People with abnormal heart rhythms could be at risk of dangerous bleeding from a serious combination of prescription medications, a new study says. Patients with atrial fibrillation (A-Fib) often are prescribed diltiazem to help control their heart rate, researchers said in the Annals of Internal Medicine . Because A-Fib also greatly increases a person’s risk of stroke, these patients also are prescribed blood thinners like apixaban or rivaroxaban , researchers said. But the combination of diltiazem with either of those blood thinners caused higher rate of serious bleeding events among a group of 23,000 patients, researchers found. “Although diltiazem remains an appropriate and effective option for heart rate control in selected patients, our results underscore that bleeding risk must be a central consideration in treatment decisions,” lead researcher Ghadeer Dawwas said in a news release. She’s an assistant professor of medicine and health policy at Vanderbilt University Medical Center in Nashville, Tennessee. Diltiazem is a calcium channel blocker, which helps slow heart rate in people with A-Fib and weaken the heart’s contraction, according to the American Heart Association . However, diltiazem also inhibits the function of cytochrome enzymes, which are crucial for the metabolism of drugs. This might cause blood thinners to become more concentrated in the bloodstream, increasing the risk of dangerous bleeding, researchers said. For this study, researchers compared 23,000 A-Fib patients prescribed diltiazem against another 23,000 prescribed metoprolol , a beta blocker also used to slow the heart rate in these patients. These patients also had been prescribed either apixaban or rivaroxaban. The team tracked which drug combination caused a higher risk of dangerous bleeding in the brain, GI system or elsewhere in the body. Results showed 467 serious bleeding events among diltiazem users compared to 397 among those prescribed metoprolol. Overall, diltiazem was associated with an 18% increased risk of dangerous bleeding, the study found. Further, the risk grew with higher doses of diltiazem, researchers discovered. The bleeding risk “is especially relevant for patients receiving higher doses exceeding 120 mg/day of diltiazem or those taking additional interacting medications,” Dawwas said. “In such cases, metoprolol may represent a safer alternative.” Sources Vanderbilt University, news release, Feb. 26, 2026

AHADrug ApprovalClinical Study

100 Deals associated with Apixaban

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KEGG	Wiki	ATC	Drug Bank
D03213	Apixaban	B01AF02	DB06605

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Recurrent deep vein thrombosis	European Union	Accord Healthcare SLU	23 Jul 2020
Recurrent deep vein thrombosis	Iceland	Accord Healthcare SLU	23 Jul 2020
Recurrent deep vein thrombosis	Liechtenstein	Accord Healthcare SLU	23 Jul 2020
Recurrent deep vein thrombosis	Norway	Accord Healthcare SLU	23 Jul 2020
Thrombosis	China	Bristol-Myers Squibb/Pfizer EEIG	22 Jan 2013
Ischemic stroke	Japan	Bristol-Myers Squibb KK	25 Dec 2012
Systemic embolism	Australia	Bristol Myers Squibb Co.	21 Jul 2011
Atrial Fibrillation	European Union	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Atrial Fibrillation	Iceland	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Atrial Fibrillation	Liechtenstein	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Atrial Fibrillation	Norway	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Embolism	European Union	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Embolism	Iceland	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Embolism	Liechtenstein	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Embolism	Norway	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Pulmonary Embolism	European Union	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Pulmonary Embolism	Iceland	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Pulmonary Embolism	Liechtenstein	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Pulmonary Embolism	Norway	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011
Stroke	European Union	Bristol-Myers Squibb/Pfizer EEIG	18 May 2011

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Chronic Limb-Threatening Ischemia	Phase 3	Brazil	Wyeth AB	09 Jan 2020
Limb injury	Phase 3	Brazil	Wyeth AB	09 Jan 2020
Cognitive Dysfunction	Phase 3	United States	Pfizer Inc.	19 Dec 2018
Cognitive Dysfunction	Phase 3	United States	Bristol Myers Squibb Co.	19 Dec 2018
Basal Cell Carcinoma	Phase 3	Austria	Bristol Myers Squibb Co.	11 Oct 2018
Basal Cell Carcinoma	Phase 3	Belgium	Bristol Myers Squibb Co.	11 Oct 2018
Basal Cell Carcinoma	Phase 3	Canada	Bristol Myers Squibb Co.	11 Oct 2018
Basal Cell Carcinoma	Phase 3	France	Bristol Myers Squibb Co.	11 Oct 2018
Basal Cell Carcinoma	Phase 3	Greece	Bristol Myers Squibb Co.	11 Oct 2018
Basal Cell Carcinoma	Phase 3	Italy	Bristol Myers Squibb Co.	11 Oct 2018

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03192215 (ARCADIA, Pubmed \| Heart)	Phase 3	Cryptogenic Ischemic Stroke	881	Apixaban	azsjhdfcuu(bckyohbznr): HR = 0.72 (95.0% CI, 0.54 - 0.95) View more	Positive	20 Feb 2026
				Aspirin
ASCO_GI2026	Not Applicable	Venous Thromboembolism	2,526	Apixaban	cqpldxcgzv(uaztdjjxwg): HR = 0.92 (95.0% CI, 0.81 - 1.06), P-Value = 0.257 View more	Positive	08 Jan 2026
				Rivaroxaban
ASH2025	Not Applicable	Venous Thromboembolism	2,792	Apixaban 2.5 mg BID	mojeoztlpb(emkeunacff): HR = 0.75 (95.0% CI, 0.68 - 0.82) View more	Positive	06 Dec 2025
				Apixaban 5 mg BID
ASH2025	Not Applicable	Atrial Fibrillation	32,294	Apixaban or Rivaroxaban with Amiodarone	xmzibdfeuh(qqwinswyee) = vaftnorcil hfslzhdbul (xxmzutlmjd )	Positive	06 Dec 2025
				Apixaban or Rivaroxaban with Flecainide or Sotalol	xmzibdfeuh(qqwinswyee) = npgolrfqfe hfslzhdbul (xxmzutlmjd )
ASH2025	Not Applicable	Fibrosis \| Portal Vein Thrombosis	312	Apixaban	aptdpaqdbe(ulwymwmmhz) = ghoamtsxrv fattrlbout (pnlnvjezkj ) View more	Positive	06 Dec 2025
				Rivaroxaban	aptdpaqdbe(ulwymwmmhz) = csofqeajel fattrlbout (pnlnvjezkj ) View more
PREVAPIX-ALL (ASH2025)	Not Applicable	-	19	DOAC	nyikkdgvka(lupiipvubq) = bigvevaxrc fvmfcnavyb (mruiypsljq ) View more	Positive	06 Dec 2025
ASH2025	Not Applicable	Hemophilia \| Atrial Fibrillation	21	Aspirin 81 mg (ASA)	tgkcrldfxw(jqkuccwtet) = mewmessryd khutkmuxkk (ezcvnxkvaa ) View more	Negative	06 Dec 2025
NCT04850378 (Pubmed \| Kidney Med)	Phase 1/2	Nephrotic Syndrome	21	Apixaban 5 mg (Nephrotic Syndrome)	qywfhoklhy(rmkylcgtet) = abahajlqmp mzsapadlin (ppfjqpmplu, 28 - 43)	Positive	01 Dec 2025
				Apixaban (Healthy individuals)	tmeelfrznh(asqpodtlgq) = gfzgyhmdxx togatjxzzx (vidjrdoxsr, 713 - 1107) View more
NCT01938248 (ARTESiA, Pubmed \| JAMA Cardiol)	Phase 4	Atrial Fibrillation	3,961	Apixaban 5 mg, twice daily (2.5 mg twice daily when indicated)	vyypnoambe(hnzxwcqsht) = swrwdnzvmx qcreoqpqvb (hryumiwmig ) View more	Positive	01 Dec 2025
				Aspirin 81 mg, once daily	vyypnoambe(hnzxwcqsht) = vggsaanjye qcreoqpqvb (hryumiwmig ) View more
NCT04168203 (HI-PRO, CTgov)	Phase 4	Pulmonary Embolism \| Venous Thrombosis \| Venous Thromboembolism	600	Apixaban 2.5 MG (Extended Duration Thromboprophylaxis)	tqgulugqae = jrmbdqwhqd nrkvtpucgv (qgrxxhcfms, nnvimzgqlk - xoksyfvwkr) View more	-	30 Sep 2025
				Placebo oral tablet (Control)	tqgulugqae = sirigrnjxs nrkvtpucgv (qgrxxhcfms, awwpocxyre - gzlajpelwv) View more