Efficacy and safety of apixaban versus rivaroxaban in acute venous thromboembolism: a systematic review and meta-analysis.

What was studied

This review pooled the results of earlier studies. It looked at adults with a sudden blood clot in a vein. It compared 2 blood thinner pills, apixaban and rivaroxaban. The team searched 3 study databases up to April 2026. In all, 13 studies with 233,569 people were included. Most only watched care, and just one was a randomized trial.

What they found

New clots overall were not clearly fewer with apixaban. New deep vein clots were lower with apixaban, based on 2 studies. Clots in the lung and deaths did not clearly differ. Apixaban was linked to less major bleeding. It was also linked to less gut bleeding and other relevant bleeding. Bleeding inside the head did not clearly differ.

What it means for patients

The authors say both drugs worked in a broadly similar way. Apixaban may lead to less bleeding than rivaroxaban. The authors say the results should be read with care.

Why it is not certain yet

Most of the data came from studies that only watched care. Only one randomized trial was part of the review. Results also varied between the studies. The certainty of the evidence was rated low to very low. A review can only be as good as the studies in it.

Source

Efficacy and safety of apixaban versus rivaroxaban in acute venous thromboembolism: a systematic review and meta-analysis.

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