Extended DOAC strategies-venous thromboembolism

• After ≥6 mo of anticoag, following regimens compared w/ no extended Rx (or ASA):

Full-dose DOAC:

* 80–90% ↓ recurrent VTE, 2–5× bleeding,
* but no signif excess in major bleeding
* (NEJM 2010;363:2499; 2013;368:699 & 709)

½ dose apixa or riva:

* ≥75% ↓ recur. VTE,
* w/o ↑ bleeding (NEJM 2013;368:699 & 2017;376:1211)