An international clinical trial led by the Ottawa Hospital that compared two commonly used drugs for the treatment of venous blood clots is being published in the New England Journal of Medicine. According to the Ottawa Hospital, the first clinical trial to compare two drugs against each other for venous thrombosis treatment – or blood clots usually found in the leg — has found a “clear winner.” “The results are very exciting,” Dr. Lana Castellucci, senior scientist and thrombosis physician at The Ottawa Hospital and professor at the University of Ottawa, told CTV News Ottawa. “We have shown that one blood thinner is safer with respect to fewer bleeding complications than another blood thinner,” she says. “Safer with fewer bleeding events.” The trial put apixaban head-to-head with rivaroxaban, showing that “7.1 per cent of participants who received rivaroxaban experienced clinically relevant bleeding after three months compared to 3.3 per cent of participants who received apixaban, representing more than double the risk of bleeding with rivaroxaban.” “This is really great for patients,” she says. “When we have to treat people with blood clots, we always worry about what their bleeding risk is. And we want to lower that as best we can. And so now we know that there’s a medication that can help reduce that risk even further.” “So, for most patients where we would prescribe a direct anticoagulant, which is the class that these drugs fall under, apixaban would largely be the drug we’re using,” says Castellucci. According to the Hospital, venous thrombosis occurs “when a blood clot lodges in the veins of the legs or lungs. It is the third leading cause of cardiovascular death after heart attack and stroke and is the most common preventable cause of death in hospitalized patients.” New England Journal of Medicine The trial is being published in the New England Journal of Medicine, an exciting achievement for the team involved with this research. “It is the pinnacle of where we aim to publish our trials. So, this is very exciting for all of us. This is something that we feel will change clinical practice guidelines,” says Castellucci. The trial, led by researchers at The Ottawa Hospital, aimed to directly compare “bleeding with apixaban and rivaroxaban in venous thrombosis patients. The trial enrolled 2,760 participants from 32 sites across Canada, Australia and Ireland.” Blood clots “I probably would have died,” Ottawa Hospital patient Janice Duval told CTV News Ottawa, sharing her story about a blood clot in her leg which she says spread to her lungs. “I got the phone very and quickly dialed 911.” Duval says in 2017, six weeks after receiving hip surgery she woke up with difficulty breathing. “I went to bed Friday night. Everything was fine. I got up Saturday morning, and I thought I had the flu. And I went to make a cup of coffee. I couldn’t even stand at the counter and all of a sudden, I thought, ‘you’re not breathing properly,’” she says. “The last thing that I remember until I got here (to the Ottawa Hospital) was the ambulance attendant said, ‘look at the size of her foot.’” Duval says the blood clot had broken into pieces and went into her lungs. After receiving treatment, Duval is now on a blood thinner and says this type of research is “wonderful.”
