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The Safety and Efficacy of Apixaban (Eliquis) in 5017 Post-bariatric Patients with 95.3% Follow-up: a Multicenter Study

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Abstract

Background

Thromboprophylaxis in bariatric surgery is widely debated; however, few large articles evaluate treatment plans and their efficacy. Herein, we make the first large-scale report of the safety and efficacy of apixaban (Eliquis) for thrombus prevention following bariatric surgery.

Purpose

To evaluate the safety and efficacy of apixaban following bariatric surgery.

Setting

Three private institutes, USA.

Materials and Methods

Data from 5017 consecutive bariatric patients that were placed on postoperative apixaban for thromboprophylaxis were used for retrospective analysis. The dose prescribed to patients was 2.5 mg PO BID for a total of 30 days starting on day 3 postoperatively.

Results

In total, of the 5017 patients, 59.7%, 31.2%, 4.4%, 2.5%, 1.8%, and 0.1% of the patients had undergone sleeve gastrectomy (SG), single-anastomosis duodeno-ileal bypass with SG (SADI-S), Roux-en-Y gastric bypass (RYGB), conversion from SG to SADI, small bowel reconstruction, and RYGB reversal, respectively. The 30-day follow-up rate was 95.3%. In total, 1.7% of patients experienced apixaban-related side effects. The most common side effects were menorrhagia and rash. Two (0.03%) side effects developed into Clavien-Dindo grade II complications. Overall, 10 (0.1%) patients experienced thromboembolic complications (five (0.09%) PVTs and five (0.09%) PEs). In each case, the protocol was not followed for extenuating circumstances. There were no deaths or thromboembolic events in cases where the protocol was able to be fully followed.

Conclusions

In conclusion, 30 days of postoperative apixaban appears to be safe and effective with minimal side effects while preventing thromboembolic events.

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Author information

Authors and Affiliations

  1. Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, USA

    Amit Surve, James Potts, Daniel Cottam, Walter Medlin, Christina Richards & Legrand Belnap

  2. Northwell Health-Lenox Hill Hospital, New York City, NY, USA

    Mitchell Roslin

  3. North Florida Surgeons, Jacksonville, FL, USA

    Miro Uchal

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  1. Amit Surve
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Corresponding author

Correspondence to Daniel Cottam.

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Conflict of Interest

Amit Surve, M.D., has no conflict of interest. James Potts, MA, has no conflict of interest. Daniel Cottam, M.D., reports personal fees and others from Medtronic and GI Windows outside the submitted work. Mitchell Roslin, M.D., F.A.C.S., F.A.S.M.B.S., is an educational consultant at Johnson & Johnson Inc., Covidien Ltd., and W. L. Gore & Associates and receives compensation from these companies. Additionally, he is on the scientific advisory board at SurgiQuest and ValenTx and has stocks options in these companies. Walter Medlin, M.D., F.A.C.S., has no conflict of interest. Miro Uchal, M.D., F.A.C.S., has no conflict of interest. Christina Richards, M.D., F.A.C.S., has no conflict of interest. Legrand Belnap, M.D., has no conflict of interest.

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Key Points

• 1.7% of patients experienced apixaban-related minor side effects.

• 0.1% of patients experienced thromboembolic events.

• There were no deaths or thromboembolic events in cases where the protocol was able to be fully followed.

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Surve, A., Potts, J., Cottam, D. et al. The Safety and Efficacy of Apixaban (Eliquis) in 5017 Post-bariatric Patients with 95.3% Follow-up: a Multicenter Study. OBES SURG 32, 1–6 (2022). https://doi.org/10.1007/s11695-022-06051-7

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  • DOI: https://doi.org/10.1007/s11695-022-06051-7

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