Disclosures: The authors report no relevant financial disclosures.
February 23, 2021
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Eliquis linked with lower risk for post-polypectomy bleeding

Disclosures: The authors report no relevant financial disclosures.
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Patients who received Eliquis were at lower risk for post-polypectomy bleeding and thromboembolism than those who received warfarin and other direct oral anticoagulants, according to study results.

Francis KL Chan, from the department of medicine and therapeutics at The Chinese University of Hong Kong, and colleagues wrote that the difference among competing anticoagulants in terms of post-polypectomy bleeding risk has not been fully explored.

“In this territory-wide population-based study, we aimed to evaluate the bleeding and thromboembolic risks after colonoscopic polypectomy among warfarin and [direct oral anticoagulants (DOAC)] users to address the current knowledge gap and unmet clinical need,” they wrote.

Researchers collected data from patients who received an oral anticoagulant and underwent a colonoscopy with polypectomy between 2012 and 2020 (n = 3,887). The primary outcome of the study was clinically significant delayed post-polypectomy bleeding (PPB), defined as repeat colonoscopy requiring hemostasis within 30 days. Investigators also explored 30-day blood transfusion requirements and new thromboembolic events.

Chan and colleagues determined that Eliquis (apixaban, Bristol Myers Squibb, Pfizer) was associated with lower PPB risk than warfarin (adjusted HR = 0.39; 95% CI, 0.24-0.63), while dabigatran (aHR = 2.23; 95% CI, 1.04-4.77) and rivaroxaban (aHR = 2.72; 95% CI, 1.35-5.48) were associated with higher PPB risk than apixaban.

Apixaban was also associated with lower risk than warfarin for thromboembolic events (aHR = 0.22; 95% CI, 0.11-0.45). Dabigatran (aHR = 2.23; 95% CI, 1.04-4.77) and rivaroxaban (aHR =2.72; 95% CI, 1.35-5.48) were associated with higher thromboembolic risk than apixaban.

“Our population- based study with propensity-weighting analysis demonstrated that apixaban was associated with a lower risk of bleeding and thromboembolic events than warfarin, dabigatran and rivaroxaban after colonoscopic polypectomy,” Chan and colleagues wrote. “High-risk subgroups including older patients aged at least 70 years or those with right-sided polyps, may warrant special attention in their peri- procedural anticoagulation plan.”