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Topics:
Medical Oncology • Internal Medicine • Hematology • Benign Hematology • Hemostasis/Thrombosis
In a patient with breakthrough VTE on rivaroxaban, would you switch to apixaban or an agent with a different mechanism of action?
Assuming the patient is a candidate for all anticoagulation options (no mechanical valve, antiphospholipid syndrome, patient-specific contraindications, of low bleeding risk, etc.) and had true rivaroxaban failure
Answer from: at Academic Institution
A complex situation and a lot will depend on the clinical circumstances e.g., compliance, type of failure, etc. I would still consider apixaban. However, if the failure was a more serious event, consider alternative anticoagulants.
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