The aim of anticoagulant therapy in patients with symptomatic venous thromboembolism is to reduce the thrombotic burden and to prevent recurrent disease. The current standard treatment consists of 5–10 days of body weight-adjusted subcutaneous low molecular weight heparin (LMWH) followed by 3–12 months of vitamin K antagonists (VKAs) . Although very effective, this therapy is cumbersome because of the need for injections initially and frequent laboratory monitoring and dose adjustments during the entire treatment period . Presently, most patients with venous thromboembolism are admitted to the hospital for only 1 or 2 days or treated entirely at home. This further increases the demand for a simple, preferably oral, treatment strategy that can be given in a fixed dose [3,4].
Apixaban is a potent reversible direct inhibitor of activated factor X that can be administered orally. In the prevention of venous thromboembolism following major orthopedic surgery, this novel anticoagulant has recently shown great promise . Therefore, apixaban might be an alternative to LMWH and VKAs in the treatment of patients with established venous thromboembolism. Hence, a dose-ranging study was conducted in patients with proven deep vein thrombosis (DVT), comparing the efficacy and safety of three dosage regimens of apixaban with that of LMWH combined with VKAs.