S01E27 | Apixaban vs Rivaroxaban in Acute VTE: The COBRRA...

What this episode covers

In this episode of PRISM Rounds, we break down the new NEJM 2026 COBRRA trial comparing apixaban vs rivaroxaban for acute venous thromboembolism (VTE).Bottom line: in this randomized head-to-head trial, apixaban reduced clinically relevant bleeding compared with rivaroxaban (3.3% vs 7.1%; RR 0.46), including lower major bleeding (0.4% vs 2.4%), with similar observed recurrent symptomatic VTE rates (1.1% vs 1.0%) over 3 months. NEJM trial: Castellucci LA, Chen VM, Kovacs MJ, et al. Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism. N Engl J Med. 2026;394:1051-1060. DOI: 10.1056/NEJMoa2510703. PubMed: https://pubmed.ncbi.nlm.nih.gov/?term=10.1056%2FNEJMoa2510703NEJM editorial: Moores LK. The COBRRA Trial — Ending the Venous Thromboembolism Safety Toss-up. N Engl J Med. 2026. DOI: 10.1056/NEJMe2600525. PubMed: https://pubmed.ncbi.nlm.nih.gov/?term=10.1056%2FNEJMe2600525Tags#PRISMRounds #MedicalPodcast #MedPodcast #JournalClub #FOAMed #MedEd #EvidenceBasedMedicine #NEJM #JAMA #JAMAInternalMedicine #VTE #VenousThromboembolism #DVT #DeepVeinThrombosis #PE #PulmonaryEmbolism #Apixaban #Rivaroxaban #DOAC #DOACs #Anticoagulation #Thrombosis #Bleeding #BleedingRisk #Hematology #ThrombosisResearch #InternalMedicine #HospitalMedicine #CriticalCare #ICU #PulmCrit #EmergencyMedicine #EM #CardiovascularMedicine #Pharmacy #ClinicalResearch #RCT #RandomizedTrial #PragmaticTrial #COBRRA #PulmonaryCriticalCare #Trainees #Residents #Fellows #MedTwitter #ClinicianEducation #PracticeChanging #NEJMArticle #AcuteVTE

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Frequently Asked Questions

How long is this episode of PRISM Rounds: Pulmonary, Critical Care & Sleep Medicine?

This episode is 24 minutes long.

When was this PRISM Rounds: Pulmonary, Critical Care & Sleep Medicine episode published?

This episode was published on March 20, 2026.

What is this episode about?

In this episode of PRISM Rounds, we break down the new NEJM 2026 COBRRA trial comparing apixaban vs rivaroxaban for acute venous thromboembolism (VTE).Bottom line: in this randomized head-to-head trial, apixaban reduced clinically relevant bleeding...

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