So here's the crazy thing. My last podcast was in January of 2022, so I've been gone from

medical podcasting for over four years. What was I doing during all that time? Well, I decided if I got

on the internet and argued with a bunch of strangers about politics, the world would be a better

place. And the fortunate thing is, it worked. And since there's really not many problems going

on right now, I figured this is a good time to return to medical podcasting. And not only did

so many problems in life get resolved around the globe,

there were a lot of medical issues that got resolved,

and one of the big ones was a month ago

in the March 2026 New England Journal Medicine called the Cobra Trial.

Now this was a big deal because it looked at a Pixaban, a lot of you call

Eloquist or River Roxaban, which a lot of you call Zaralto. And in the past, there's never been a

head-to-head trial to know which one is the better one to use. At least no large head-to-had

randomized control trial until now

with the Cobra trial. And in case you're wondering what Cobra stands for, it is the comparison

of bleeding risk between River Roxaban and Apixaban. And what we know about those direct oral anticoagulant drugs is they have been the first-line

therapy for acute venous thromboembolism.

So DVT, deep vein thrombosis, PE, pulmonary embolism, you want to use those medications

over a vitamin K antagonist like

kumidin warfarin and that's because the safety profile is so much better than the vitamin

K antagonist. We are the first do-no-harm crew. We do not want to do harm. We leave that to the insurance companies.

I do think this trial falls into a practice changing trial because in this trial,

a pixaband not only had the same efficacy, it was much safer.

...