Reduced-Dose Apixaban for Cancer-Associated Thrombosis: A New Standard?

Send us a textIn this episode of Clot Conversations, Dr. Lana Castellucci, University of Ottawa, discusses the COBRA study, which compares the bleeding risks of rivaroxaban and apixaban in patients with acute VTE. The study follows patients for three months and finds that apixaban significantly reduces combined bleeding events compared to rivaroxaban. While the trial wasn't powered for individual outcomes, it shows no difference in VTE recurrence. This is potentially practice-changing information, indicating that most acute VTE patients might benefit from apixaban over rivaroxaban, although patient-specific factors and preferences will still play a role in decision-making.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textIn this episode of CLOT Conversations, Dr. Gregoire Le Gal, University of Ottawa, in an interview with Dr Vicky Mai, shares insights from his groundbreaking study on age-adjusted D-dimer cutoffs for diagnosing deep vein thrombosis (DVT). Previously validated for pulmonary embolism (PE), this new approach significantly improves DVT diagnostics. By adjusting D-dimer thresholds based on patient age, the study found a safe and reliable method to rule out DVT without reliance on additional imaging. Though results showed a smaller incremental increase in negative D-dimer results compared to PE, the safety of the approach was confirmed. This research simplifies DVT diagnostics, making it easier for clinicians, especially in emergency settings.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textIn this podcast episode, we explore groundbreaking research presented at the ISTH 2025 in Washington. Dr. Vicky May, Institut Universitaire de Cardiologie et Pneumologie de Québec, shares insights into a new diagnostic algorithm for pulmonary embolism (PE) in patients with chronic obstructive pulmonary disease (COPD). Her work focuses on identifying specific predictors, integrating these with established testing methods, and addressing challenges in the validation process. The discussion also highlights a study on recurrent venous thromboembolism (VTE), emphasizing symptom patterns and recurrence likelihood. These findings aim to refine clinical diagnostics, offering physicians refined tools for better patient management in thrombosis-related conditions.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textIn this episode of Clot Conversations, Dr. Tzu-Fei Wang, Ottawa, shares a summary of her presentations at the 2025 ISTH meeting on recent studies on drug interactions in prostate cancer therapy and the use of anticoagulants. Dr Wang also highlights the significance of the WAVe study in assessing dalteparin use without the traditional dose cap in patients over 90 kg. These findings offer reassurance to clinicians prescribing anticoagulation therapy, minimizing previous concerns. The discussion provides optimism for improved cancer care protocols, showcasing safer, more effective anticoagulation practices for patients..Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textIn this episode of Clot Conversations, hosts Jamil Abdulrehman, and Maha Othman interview Dr Stephanie Young from Memorial University in St John's, Newfoundland, at the 2025 ISTH meeting about her presentations on the complexities of patient experiences with Venous Thromboembolism (VTE). Dr Young shares findings from a qualitative study that highlight the uncertainties and emotional impacts patients face along their care journey. Key themes include the need for clearer care pathways, better access to specialized services, and greater involvement in decision-making. The discussion emphasizes integrating patient insights into clinical guidelines to enhance VTE care, aiming for a more patient-centered approach that accounts for both physical and psychological needs.Dr Young also references the Thrombosis Canada patient resources that can be found here: https://thrombosiscanada.ca/patients_and_caregiversSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textIn the latest episode of 'Clot Conversations,' host David Airdrie and guest Dr. Vinai Bhagirath, alongside a talented group of researchers, delve into groundbreaking thrombosis research presented at ISTH 2025. Highlights include Amulya Bhagirath's work on a computerized decision support system for anticoagulation, Dr. Alejandro Godoy's international study on LMWH bridging in patients with mechanical heart valves, Tegvir Grewal's work on perioperative anticoagulation of mechanical aortic valve patients for GI endoscopy and Julia Sharobim's work on transcatheter aortic valve replacement. These studies underline the importance of innovative approaches in thrombosis management, emphasizing Canada's role in driving global research. With promising new insights and collaborations across the globe, this episode showcases the exciting future of thrombosis research.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textCLOT Conversations hosts Dr Maha Othman and Dr Jameel Abdulrehman interview Prof Elvira Grandone about two of her presentations at the 2025 ISTH conference in Washington, DC. The first is a discussion about the results of the FIRST Registry that reviews the efficacy of antithrombotic drugs in pregnancy (session OC 05.1). The second is a discussion of the Pregnancy-Associated Thrombosis Hemorrhage and Anemia (PATH) project. The study aims to examine awareness, current practices and barriers to early identification of anemia and its management in pregnancy. All healthcare professionals involved in the diagnosis and management of anemia in pregnancy. For more information and to participate go to https://REDCap.link/ISTH-PATHSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textIn this episode of CLOT Conversations, we sit down with Dr. Marc Carrier to explore a groundbreaking study published in the New England Journal of Medicine on reduced-dose apixaban for cancer-associated venous thromboembolism (VTE). Dr. Carrier breaks down the study’s findings, which suggest that a lower dose of apixaban after six months of treatment is just as effective in preventing clot recurrence — and significantly safer in terms of bleeding risk. Tune in for expert insights on how this data could shift clinical practice and improve outcomes for patients living with cancer.Reference:Mahé I, Carrier M, Mayeur D, Chidiac J, Vicaut E, Falvo N, Sanchez O, Grange C, Monreal M, López-Núñez JJ, Otero-Candelera R. Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism. New England Journal of Medicine. 2025 Mar 29.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textDrs. Mithoowani and Siegal discuss new expert guidance for managing severe bleeding in patients taking oral anticoagulants, including identifying those at risk, optimizing supportive measures, treating the source of bleeding, and administering reversal agents. It includes discussion of the algorithm for use at the point of care that helps identify patients at risk of adverse outcomes, optimize supportive measures, treat the source of bleeding, and administer anticoagulant reversal or hemostatic therapies.Abstract: http://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2464-2887 Full text HTML: http://www.thieme-connect.com/products/ejournals/html/10.1055/a-2464-2887 Full text PDF: http://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-2464-2887.pdf Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a textDr Tony Wan shares the results of a study that examined the effectiveness of an anticoagulation stewardship program (ACSP) in improving adherence to venous thromboembolism (VTE) prophylaxis guidelines and reducing costs at a Canadian teaching hospital. Here what he has to say about the results and the process of setting up the study in his hospital.Tony Wan, Stephanie J. Garland, Chipman Taylor Drury, Justin Lambert, Joshua Yoon, Melissa Chan, Anticoagulation stewardship: Improving adherence to clinical guidelines and reducing overuse of venous thromboembolism prophylaxis in hospitalized medical patients, Thrombosis Research, Volume 239, 2024, https://www.sciencedirect.com/science/article/pii/S0049384824001622 Donate to Thrombosis Canada: https://thrombosiscanada.ca/donateSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada