Discoveries for life

Anticoagulant clinical trial could change care for patients with blood clots

Dr. Lana Castellucci
Scientist, Inflammation and Chronic Disease Program and Professor, Medicine
Ottawa Hospital Research Institute and University of Ottawa

Venous thromboembolism (thrombosis) is a serious health concern involving blood clots in the veins of the legs. Affecting approximately 50,000 people each year in Canada, this condition can lead to complications such as pulmonary embolism, which is when blood clots travel to the lungs.

Doctors often prescribe anticoagulants such as apixaban and rivaroxaban to treat blood clots, but a side effect is bruising or internal bleeding. A CIHR-funded clinical trial led by Dr. Lana Castellucci compared the bleeding risk of these medications when given to patients newly diagnosed with thrombosis. Involving 2,760 participants in 32 sites across Canada, Australia, and Ireland, the COBRRA study found that apixaban reduced bleeding by more than 50% compared to rivaroxaban.

For people living with venous thromboembolism, this means fewer risks. "Patients with thrombosis often live with the dual fear of recurrence and bleeding, so knowing that a safer treatment option is available brings real peace of mind," says one trial participant.

Dr. Castellucci's clinical trial began as a pilot study funded by CanVECTOR, a network that has advanced research on venous thromboembolism in Canada for a decade. The success of the pilot study led to the larger international clinical trial. Dr. Castellucci reflects that, by investing in CanVECTOR, CIHR "has helped build a community of researchers and patient partners who are working to make care safer and more effective—not just in Canada, but globally."

Further reading

• Lana Castellucci - Ottawa Hospital Research Institute
• International Network of Venous Thrombosis Clinical Research Networks
• The COBBRA Study: Shifting Paradigms in Acute VTE Treatment

Improving arthritis care in Indigenous communities

Dr. Cheryl Barnabe, MD, MSc, FRCPC
Director and Chair, McCaig Institute for Bone and Joint Health
Canada Research Chair, Rheumatoid Arthritis and Autoimmune Diseases
Arthur J.E. Child Chair in Rheumatology Research
Professor, Departments of Medicine and Community Health Sciences, University of Calgary
Rheumatologist, Alberta Health Services

Inflammatory arthritis, including conditions such as rheumatoid arthritis, disproportionately impact Indigenous communities in Canada because of limited access to high-quality health care services. To address these disparities, we are working closely with Indigenous communities and patients to create solutions that meet their needs.

A key outcome of this joint effort is the 'Arthritis Liaison' program. This initiative embeds a trusted community member in the health care team to help patients navigate the system and achieve personal health goals. The program also builds a strong network for peer support within the community.

As part of this program, we developed patient decision aids to facilitate shared decision-making between Indigenous patients and health care providers. These tools help Indigenous patients understand their arthritis treatment options, weighing risks and benefits of these treatments, and aligning treatment choices with their preferences, expectations, and values.

Further reading

• McCaig Institute website