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December 8, 2025Blood

Comparative safety and effectiveness of apixaban versus warfarin in antiphospholipid syndrome with chronic kidney disease: A real-world propensity-matched cohort study

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Authors

FKFayaz KhanZAZuhair Alam

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Overview

Retrospective cohort study reveals lower major bleeding and mortality rates with apixaban in APS patients with chronic kidney disease, suggesting a safer option than warfarin.

Key Points

  • To compare the safety and effectiveness of apixaban versus warfarin in patients with antiphospholipid syndrome and chronic kidney disease.
  • Conducted a retrospective cohort study using TriNetX US Collaborative Network
  • Included adults with antiphospholipid syndrome and stage 3-5 chronic kidney disease
  • Performed propensity score matching resulting in 523 matched patients per group
  • Compared outcomes using Kaplan-Meier analysis and reported hazard ratios
  • Apixaban associated with lower major bleeding risk compared to warfarin (HR 0.46)
  • Apixaban showed lower all-cause mortality (HR 0.51) than warfarin
  • No significant differences in risks of thrombotic events or gastrointestinal bleeding between groups

Cite This Study

Khan et al. (2025) studied this question.

synapsesocial.com/papers/693624d44fa91c937236d04ahttps://doi.org/10.1182/blood-2025-318
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced CKD Not Requiring Dialysis2026
  2. 2Safety and Effectiveness of Apixaban Versus Warfarin in Peritoneal Dialysis Patients with Newly Diagnosed Nonvalvular Atrial Fibrillation2026
  3. 3Comparative Efficacy and Safety of Novel Oral Anticoagulants in Atrial Fibrillation with Chronic Kidney Disease: A Systematic Review, Meta-Regression, and Network Meta-Analysis2025
  4. 4Real-world outcomes of direct oral anticoagulants versus warfarin in patients with single-positive antiphospholipid antibody syndrome: A trinetx cohort analysis2025
  5. 5Comparing outcomes using low‐dose apixaban and anti‐Xa monitoring and vitamin K antagonists in patients with renal replacement therapy2026