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Pulmonary vascular disease & thromboembolismRandomised controlled trial

Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism

N Engl J MedPublished

  • Randomised controlled trial
  • prospective
  • open-label
  • blinded end-point
  • international
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Authors' conclusion

Among patients with acute venous thromboembolism, the risk of clinically relevant bleeding was significantly lower with apixaban than with rivaroxaban during the 3-month treatment period.

Study context

Population
Patients with acute symptomatic PE or proximal DVT
Participants
2,760 patients
Comparison
Apixaban vs rivaroxaban
  • Apixabann = 1,370
  • Rivaroxabann = 1,390reference
Primary endpoint
Clinically relevant bleeding (major or clinically relevant nonmajor bleeding, ISTH definition)
Follow-up
3-month trial period

Primary result

As reported in the abstract

Relative risk

0.46

95% CI 0.33–0.65

P < 0.001

Events by treatment group

Apixaban vs Rivaroxaban
RR 0.46 (95% CI 0.33–0.65); P < 0.001

Secondary outcomes

OutcomeApixabanRivaroxabanRR (95% CI)
Death from any cause0.1%0.3%0.25 (0.03–2.26)

Safety

Serious adverse events unrelated to bleeding or venous thrombosis

Original publication

Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism. N Engl J Med. Published 12 March 2026. doi:10.1056/nejmoa2510703
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Summarised from the published abstract; every number is checked against it