Apixaban Leads Bleeding Safety Over Rivaroxaban in Acute VTE, Study Finds

COBRRA (2760 patients, 3 months) shows apixaban reduces clinically relevant bleeding vs rivaroxaban in acute VTE (3.3% vs 7.1%), with major and clinically relevant nonmajor bleeding also lower (0.4% vs 2.4%; 2.9% vs 4.9%), while recurrent symptomatic VTE is similar (~1%). The safety edge could shift guidelines and insurer preference toward apixaban, though the study’s short follow-up and predominantly White population are limitations; a COBRA-AF trial in atrial fibrillation is planned.