Overview
Currently, Enoxaparin is the usual prophylactic anticoagulant treatment at the acute and sub-acute phases of spinal cord injury (SCI). Patients at the sub-acute phase of SCI (rehabilitation) will be given either Enoxaparin 40 mg/day (control) or Apixaban 2.5-5 mg twice a day. Apixaban dose will be determined by the treating physician. Treatment will be continued for either 6 or 12 weeks following injury (for AIS grades C-D and A-B respectively).
Endpoints: Venous thromboembolism will be evaluated by D-Dimer test every 2 weeks and an ultrasound doppler at the beginning and the end of the treatment. Bleeding events will be recorded and hematocrit will be monitored every two weeks.
Eligibility
Inclusion Criteria:
- spinal cord injury (traumatic of not traumatic), Hebrew speaker.
Exclusion Criteria:
- contra-indication for anticoagulant treatment
- concomitant treatment with any other anticoagulant
- anticoagulant treatment needed for indications other than VTE prevention following spinal cord injury
- active clinically significant bleeding
- any lesion or condition considered a significant risk factor for major bleeding.
- hepatic disease associated with coagulopathy and clinically relevant bleeding risk
- pregnancy or breast-feeding
- heart valve related issues
- galactose intolerance
- active cancer
- patients who require thrombolysis or pulmonary embolectomy
- patients with renal impairment
- sensitivity to excipients of the medication
- anti phospholipid syndrome
- prosthetic heart valve
- acute ischemic stroke