Which DOAC Bleeds Less? COBRRA Trial Insights for VTE Care with Dr Lana Castellucci

Send us Fan MailWhich DOAC bleeds less in acute VTE?In this episode, we explore the COBRRA trial comparing apixaban vs rivaroxaban and what it means for clinical practice.The COBRRA trial provides the first direct, randomized comparison of apixaban and rivaroxaban for the treatment of acute venous thromboembolism (VTE).In this episode of CLOT Conversations, Dr. Lana Castellucci discusses findings from this landmark study and how they should influence anticoagulant selection.Key insights include:Apixaban reduced clinically relevant bleeding by more than 50% compared to rivaroxabanDifferences in bleeding risk emerged early and persisted over the 3-month treatment periodRecurrent VTE and mortality rates were similar between groupsDosing strategies and early treatment phase appear to play a key roleWe also explore real-world considerations, including medication adherence, patient preference, and how to approach populations not included in the trial, such as cancer-associated thrombosis and higher body weight.This episode provides practical, evidence-based guidance for clinicians managing acute DVT and pulmonary embolism. Listen now to learn how the COBRRA trial may change your approach to DOAC selection.Access the publication here:Castellucci LA, Chen VM, Kovacs MJ, Lazo-Langner A, Greenstreet P, Kahn S, Côté B, Schulman S, De Wit K, Douketis J, Suryanarayan D. Bleeding risk with apixaban vs. rivaroxaban in acute venous thromboembolism. New England Journal of Medicine. 2026 Mar 12;394(11):1051-60.Support the showhttps://thrombosiscanada.caRegister today for our upcoming conference on November 7, 2026 in Montreal at https://thrombosiscanada.ca/2026ConferenceTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada