Betrixaban versus enoxaparin for VTE in critically ill patients: an APEX substudy

Join APEX trial investigator Dr Russell Hull for a discussion of the latest substudy exploring betrixaban versus enoxaparin for venous thromboembolism prophylaxis in critically in patients, originally presented at ESC 2018.

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Dr Russell Hull

Foothills Medical Centre and University of Calgary



Admittance of a patient to the intensive care unit (ICU) is a predictor of venous thromboembolism. In this informative journal club, Dr Russell Hull provides insights into the latest APEX trial retrospective analysis looking at extended-duration prophylaxis by betrixaban, and whether this novel regimen yielded clinical benefit with respect to reduced bleeding and VTE risk when compared with the current standard of care by enoxaparin.

  • Target audience

    This educational activity is designed for hospitalists, haematologists, interventional cardiologists, internists, surgeons, and any other healthcare professional with an interest or role in thromboprophylaxis.

  • Learning objectives

    After completing this educational activity, participants should be able to:

    • Review the risks of VTE events in critically ill patients and bleeding risk associated with conventional anticoagulation
    • Name the outcomes of treatment with extended-duration betrixaban compared with enoxaparin with respect to risk of VTE and excess major bleeding
    • Consider the data on mortality risk with the anticoagulants examined in this study and their potential impact on current clinical practice
  • Disclosures

    Prof John Camm
    Advisor for: Boehringer Ingelheim, Daiichi Sankyo
    Consultant (retained) for: Boehringer Ingelheim
    Received honoraria from: Bayer, Daiichi Sankyo, BMS-Pfizer

    Dr Russell Hull
    Received honorarium from: Portola
    Institute has received honorarium from: Portola
    PCM Scientific staff, and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

  • Funding

    This independent educational activity is supported by funding from Portola Pharmaceuticals. PCM Scientific is the medical education company acting as scientific secretariat and organiser for this programme. The activity is run independently of the financial supporter and all content is created by the faculty. No funder has had input into the content of the activity.