Apixaban for Extended Treatment of Venous Thromboembolism

Venous thromboembolism, which includes deep-vein thrombosis and pulmonary embolism, is the third most common cause of vascular disease?related deaths.1 The mainstay of treatment is anticoagulation, and guidelines recommend therapy for 3 months or longer.2,3 Decisions about extending treatment are challenging. Although warfarin is effective for the prevention of recurrent venous thromboembolism, the inconvenience of laboratory monitoring and the dietary restrictions, coupled with concerns about bleeding, often lead to a reluctance to continue warfarin therapy beyond 6 to 12 months. Attempts to reduce the risk of bleeding by lowering the intensity of warfarin therapy have resulted in decreased efficacy without . . .