{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:24:18Z","timestamp":1787300658707,"version":"build-2736575974"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Apixaban for acute venous thromboembolism (VTE) is dosed with an intensified 7-day lead-in to decrease recurrence. The optimal initiation dosing in hospitalized patients remains unknown. This study compares the safety and efficacy of apixaban maintenance versus lead-in dose initiation in hospitalized patients with acute VTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This IRB-approved, retrospective, single center, cohort study was conducted at a quaternary referral, academic medical center. Adult patients diagnosed with acute VTE who received \u22651 apixaban dose during hospitalization were eligible for inclusion. Patients initiated on apixaban \u22657\u2009days from VTE or anticoagulated within 3\u2009months prior to admission were excluded. Patients were grouped into 2 cohorts: (1) maintenance dose (MD) \u2013 no apixaban 10\u2009mg dose and (2) lead-in dose (LD) \u2013 received \u22651 apixaban 10\u2009mg dose. Outcomes were assessed for 3\u2009months following apixaban initiation. The primary outcome compared a composite endpoint of major and non-major clinically relevant bleeding (NMCRB) between groups. The secondary outcome compared a composite endpoint of recurrent VTE and all-cause mortality (VTE-M) between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 200 (28 MD, 172 LD) patients were included. Patients were 61 (48-72) years old and admitted 5 (2-12) days. Baseline characteristics were similar between groups. Parenteral anticoagulation was administered in 90% (25 [89%] MD, 156 [91%] LD) of patients prior to apixaban initiation. Time on parenteral anticoagulation was longer in MD (61 [37-88] hours] compared to LD (40 [18-65] hours) patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02). Composite major and NMCRB occurred in 6 (21.4%) MD and 21 (12.2%) LD patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.19). Composite VTE-M occurred in 2 (7.1%) MD and 16 (9.3%) LD patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study found no difference in bleeding or VTE-M in hospitalized patients with acute VTE receiving apixaban MD versus LD. The high incidence of bleeding suggests caution is needed with apixaban initiation in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00185787261476068","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:25:26Z","timestamp":1786965926000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Apixaban Lead-In Versus Lead-In Omission in Hospitalized Adults with Acute Venous Thromboembolism: A Retrospective Safety Analysis"],"prefix":"10.1177","author":[{"given":"Kelly","family":"Rice","sequence":"first","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Hoff","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Droege","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Rice","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Droege","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Federle","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savannah","family":"Ruess","sequence":"additional","affiliation":[{"name":"The Christ Hospital, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0962-1001","authenticated-orcid":false,"given":"Carolyn D.","family":"Philpott","sequence":"additional","affiliation":[{"name":"University of Cincinnati Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2024.03.003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-12-1036"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1007903"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1302507"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010199"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.2350"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/08971900251313649"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-022-02641-5"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/87551225251326436"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-025-01993-1"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-025-03199-8"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2510703"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13140"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S392505"}],"container-title":["Hospital Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00185787261476068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00185787261476068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00185787261476068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T07:47:15Z","timestamp":1787298435000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00185787261476068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":14,"alternative-id":["10.1177\/00185787261476068"],"URL":"https:\/\/doi.org\/10.1177\/00185787261476068","relation":{},"ISSN":["0018-5787","1945-1253"],"issn-type":[{"value":"0018-5787","type":"print"},{"value":"1945-1253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"00185787261476068"}}