Assessment finds some benefit of Eliquis (BMS/Pfizer) in patients with hip replacements

The German Institute for Quality and Efficiency in Health Care (IQWiG) has carried out an early benefit assessment of Eliquis (apixaban), from BMS/Pfizer, to detect any added benefits after operations to replace a hip or knee joint. Its studies showed that apixaban was more effective in preventing symptomatic Deep Vein Thrombosis than the comparator therapy: about one in 1000 patients who took apixaban developed a symptomatic Deep Vein Thrombosis; the figure for patients who injected enoxaparin was about 4 in 1000. A minor added benefit of apixaban is proven in this case. In hip replacement surgery, there was no difference between the treatment groups in respect of pulmonary embolisms. However after knee replacement, these occurred more frequently under apixaban than under enoxaparin: About 5 in 1000 patients who took apixaban had a pulmonary embolism, compared to about one in 1000 under enoxaparin. This leads to an indication of a lesser benefit of apixaban compared to the comparator therapy. The extent of this lesser benefit was classified as "considerable". From weighing up the benefits and harms on the basis of the data presented in the manufacturer's dossier, IQWiG found no proof of added benefit of apixaban over the appropriate comparator therapy in knee replacement surgery.