User:Michelletvnguyen/sandbox

Apixaban Sandbox Edit:

Mechanism of action
Apixaban is a highly selective, orally bioavailable, and reversible direct inhibitor of free and clot-bound factor Xa. Factor Xa catalyzes the conversion of prothrombin to thrombin, the final enzyme in the coagulation cascade that is responsible for fibrin clot formation. Apixaban has no direct effect on platelet aggregation, but by inhibiting factor Xa, it indirectly decreases platelet formation induced by thrombin.

Clinical trials
In a head-to-head study (Phase 3 ARISTOTLE trial ) of apixaban versus warfarin, apixaban met both its primary endpoint (“noninferiority” to warfarin in preventing strokes) and a key secondary endpoint (superior compared to warfarin in avoiding major bleeding).

A subanalysis of the ARISTOTLE trial indicates that apixaban reduces the risk of stroke regardless of blood pressure control. Additionally, the results of this trial showed that poor blood pressure control was associated with a significantly higher risk of stroke or systemic embolism in patients with atrial fibrillation, independent of apixaban or warfarin treatment.