Don't Just Read the Abstract

On this episode, Pip and Rich discuss Piazza et al. Apixaban for Extended Treatment of Provoked Venous Thromboembolism, published in the New England Journal of Medicine in August 2025. This trial randomised 600 patients with VTE provoked by a transient risk factor but who also had at least one enduring risk factor, after completing 3 months of anticoagulation, to receive either apixaban 2.5 mg twice daily or placebo for 12 months. Extended apixaban reduced recurrent VTE from 10.0% to 1.3% (HR 0.13, 95% CI 0.04–0.36) with very low rates of major bleeding, though clinically relevant non-major bleeding was more frequent.The caveat to these findings is the definition of "provoked" used in the trial, which is wide-ranging. This is an insightful discussion and is highly relevant to clinical practice. Hosted on Acast. See acast.com/privacy for more information.

Prof. Isabelle Mahé is a cardiologist, triallist, and Professor of Internal Medicine Paris Cité University, France. She recently led the API-CAT study, a randomised controlled trial of apixaban 2.5 mg BD vs 5 mg BD for treatment of patients with cancer associated venous thromboembolism after 6 months of therapy. Pip and Rich discussed API-CAT in detail in episode 20 and now seize the opportunity to speak to an international expert and leader in the field about the art of the trial. API-CAT was published in the New England Journal of Medicine in 2025, Hosted on Acast. See acast.com/privacy for more information.

In this episode, Pip and Rich go beyond the abstract of the API-CAT study, a randomised controlled trial of apixaban 5 mg BD vs 2.5 mg BD in patients with cancer-associated PE or DVT who have completed 6 months of anticoagulation. The study reported non-inferiority for low-dose apixaban in terms of VTE recurrence with a reduction in clinical relevant bleeding. This is an interesting, practice-changing study but there is plenty of nuance and a lot to discuss. Don't miss this one!HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

In this episode of Don't Just Read the Abstract, Pip and Rich critically appraise LUNA3, a 2:1 randomised controlled trial of rilzabrutinib vs placebo in adults with persistent or chronic ITP. This is the first therapy to prove an improvement in fatigue in ITP, but does it live up to expectation? Listen to this episode and find out.Do you like our show? Please share with friends, colleagues, and the wider world on social media.ReferencesKuter et al. 2025 - LUNA-3 TrialQuality of Life Outcomes in Luna-3 (ASH Poster)HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

Dr Megan Kell is a UK haematologist, currently practising in Sheffield. She is the Chair of the British Society of Haematology's Global Haematology Specialist Interest Group and has a long standing interest in Global Health. She recently returned from over two years working as one of only two haematologists in the small, west African nation of The Gambia. This is an eye-opening interview which makes you realise what we take for granted. There are some great stories in here about how to improvise, how to acquire what you need in a resource poor setting, and what's truly important in medicine. This is a must listen!HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

On this episode, Pip interviews Dr Susie Shapiro, consultant haematologist in Oxford, UK, about the recent UK approval of efanesoctocog alfa, a very long half-life factor VIII product for severe haemophilia. To find out more about this treatment, listen to our first episode on the subject (Efanesoctocog alfa - a very long half life factor VIII) where we discuss the evidence.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

On this episode, Rich and Pip discuss the very long half life factor VIII product efanesoctocog alfa (trade names Altuvoct and Altuviiio). They discuss the 2023 NEJM paper that has recently prompted its approval for use in the UK NHS. This is the first of two episodes on this subject.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

Pip and Rich discuss the happenings from day 2 of the British Society of Haematology Annual Scientific Meeting.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

On this show, Pip and Rich discuss the first day of BSH, focusing on medical haematology.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Rich and Pip review the programme for BSH 2025 and discuss the non-malignant haematology sessions not to miss. This is your go to guide for Glasgow 2025 beginning on 27th April.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology. Hosted on Acast. See acast.com/privacy for more information.

On this episode, Pip and Rich discuss Jaber et al. Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial. PEERLESS was a trial that enrolled patients with intermediate-risk (sub-massive) PE and randomised them to either large-bore mechanical thrombectomy or catheter directed thrombolysis. The headline finding from PEERLESS is that mechanical thrombectomy is superior to catheter directed thrombolysis but as ever, if you read beyond the abstract, you will find that it is much more complex than that. The study used an interesting primary endpoint called "win ratio" and the show includes a detailed explanation and analysis of what this is, its benefits, and its drawbacks.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

On this episode, Pip and Rich chat to Fouad Al Noor, CEO of ThinkSono. ThinkSono have developed an AI-powered handheld scanning tool for DVT that enables anyone to perform a diagnostic quality ultrasound scan for the diagnosis of DVT. The images are then reviewed by a radiologist, providing a rapid answer for most patients. The tool is entering use within the NHS and in this podcast, Pip and Rich discuss the story and the evidence behind ThinkSono as well as the challenges and opportunities that the tool provides.For more information, visit www.thinksono.com and to access the evidence, head to www.thinksono.com/research.Pip and Rich have no relevant conflicts of interest for this episode. The podcast was initially started thanks to a hands off grant from Sobi who have had no editorial input into the show.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Rich and Pip discuss de Latour et al. Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria. NEJM 2024. Iptacopan is a proximal complement inhibitor and the first oral treatment for paroxysmal nocturnal haemoglobinuria.The study randomised patients to either continuation of a C5 inhibitor or switch to ictacopan and found that a significant proportion of patients achieved hemoglobin levels of 120 g/L or higher without the need for transfusions. The treatment was generally well-tolerated, with a safety profile consistent with previous studies, suggesting that iptacopan is a viable alternative to existing therapies.Join us as we delve into the study's methodology, results, and implications for the future management of PNH.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Pip and Rich discuss plasma exchange free treatment of thrombotic thrombocytopenic purpura with Dr Lucas Kuhne and Professor Paul Brinkoetter, authors of a recent study in Blood: Kühne et al. Management of immune thrombotic thrombocytopenic purpura without therapeutic plasma exchange.The study is an observational, retrospective study reporting outcomes of patients with TTP who were treated without plasma exchange, which is currently considered the standard of care. The advent of a novel nanobody against vWF called caplacizumab, that targets and prevents catastrophic thrombosis that is seen in TTP, has allowed the study of this approach.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Rich and Pip discuss a paper a German/Austrian study published in Blood: Kühne et al. Management of immune thrombotic thrombocytopenic purpura without therapeutic plasma exchange.The study is an observational, retrospective study reporting outcomes of patients with TTP who were treated without plasma exchange, which is currently considered the standard of care. The advent of a novel nanobody against vWF called caplacizumab, that targets and prevents catastrophic thrombosis that is seen in TTP, has allowed the study of this approach. Rich and Pip discuss the nuances of the paper and offer critical analysis.In a follow-up episode, Rich and Pip will interview the study authors.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Rich and Pip discuss gene therapy for sickle cell disease, focusing on Frangoul et al. Exagamglogene Autotemcel for Severe Sickle Cell Disease, NEJM 2024.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Pip and Rich discuss ANNEXA-I with Dr Will Lester, consultant haematologist at University Hospitals Birmingham. ANNEXA-I was a randomised controlled trial of andexanet alfa for reversal of anti-FXa oral anticoagulants in patients with intracerebral haemorrhage. There's a lot to get your teeth stuck into so and this one is a lively discussion!Disclosure: Pip and Rich are named investigators on a grant from AstraZeneca to audit the use of reversal agents (including andexanet) across the UK. Pip has also received honoraria from AstraZeneca. Will has received honoraria from AstraZeneca. To see our full list of financial disclosures, search for us on Who Pays This Doctor.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Rich and Pip discuss the ANNEXA-I trial (https://www.nejm.org/doi/full/10.1056/NEJMoa2313040). This was a randomised controlled trial of andexanet alfa, a decoy factor Xa molecule that is a reversal agent for oral factor Xa inhibitors. Patients were randomised to andexanet alfa or usual care. The primary outcome was haemostatic efficacy and andexanet alfa was shown to result in better control of haematoma expansion compared to usual care. However, there are many discussion points here not least the validity of the surrogate outcomes used in the trial.Disclosure: Pip and Rich are named investigators on a grant from AstraZeneca to audit the use of reversal agents (including andexanet) across the UK. Pip has also received honoraria from AstraZeneca. To see our full list of financial disclosures, search for us on Who Pays This Doctor.In the next episode, Pip and Rich will discuss ANNEXA-I with Dr Will Lester.There is also a tiny mistake in the news section where Pip says that the infected blood inquiry report is 1200 pages long where in fact it is over 2500.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Rich and Pip discuss vaccine-induced immune thrombotic thrombocytopenia and heparin-induced thrombocytopenia. They critique a recent paper that has shown that VITT has been around before vaccines against Covid-19. Importantly, they discuss which patients should be tested for spontaneous VITT- and HIT-like syndromes, and discuss a recent case.The paper is: Schönborn L. et al. Anti-PF4 immunothrombosis without proximate heparin or adenovirus vector vaccine exposure. Blood. 2023 Dec 28;142(26):2305-2314.HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Pip and Rich discuss the ADVANCE IV trial: Efficacy and safety of the neonatal Fc receptor inhibitor efgartigimod in adults with primary immune thrombocytopenia: a multicentre, randomised, placebo-controlled, phase 3 trial.With the help of Professor of Immunohaematology, Prof. Nikki Cooper, Rich and Pip dissect the trial, learning loads about ITP and the difficulties of doing trials in this space.LinksBroome C et al. Efficacy and safety of the neonatal Fc receptor inhibitor efgartigimod in adults with primary immune thrombocytopenia (ADVANCE IV): a multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2023 Nov 4;402(10413):1648-1659HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever. Hosted on Acast. See acast.com/privacy for more information.