Don't Just Read the Abstract

On this episode, Pip and Rich discuss two of their recent publications on idiopathic and secondary polycythaemia. The first is an audit across two large hospitals in the Midlands. The team screened over 2000 patients who had had a JAK2 mutation screen performed, eventually finding 266 with confirmed idiopathic or secondary polycythaemia. By the time patients were seen, the haematocrit was already dropping. 60% were never venesected and venesection seemed to make no difference to haematocrits and had no association with thrombotic events. In the second paper which was a survey of clinicans, practice was, as expected, shown to be variable. 85% responded to say that they would be willing to randomise patients to a clinical trial of venesection vs no venesection.This is an interesting discussion on a common situation for which there is almost no academic interest whatsoever. However, it is a big clinical problem - there is a lot of work for haematologists here. The evidence does not support treating this group of patients in any way shape or form and a trial to prove non-inferiority of no venesection is very much needed.Here are the links to the papers: Maybury et al. Venesection and resolution of erythrocytosis are not associated with reduced thrombotic risk in secondary and idiopathic polycythaemia: Results from a dual centre, 5-year retrospective study. Br J Haematol . 2025 Sep;207(3):1127-1132. doi: 10.1111/bjh.20235Nicolson et al. Common Themes and Uncertainties in Management of Secondary Polycythaemia: An International Clinician Survey of Practice. EJHaem . 2025 Oct 27;6(6):e70171. doi: 10.1002/jha2.70171

On this episode, Pip and Rich discuss the BASIS trial which investigated the efficacy of the rebalancing agent marstacimab in people living with haemophilia. Marstacimab is an inhibitor of tissue factor pathway inhibitor (TFPI) and works by tipping the balance of clotting towards coagulation and away from bleeding. The trial showed that marstacimab works but is not randomised and there are some very interesting critical appraisal points in here even if you are not hugely interested in haemophilia.Matino et al. Marstacimab prophylaxis in hemophilia A/B without inhibitors: results from the phase 3 BASIS trial. Blood (2025) 146 (14): 1654–1663.Want a free monthly newsletter on medical haematology? Sign up at www.dontjustreadtheabstract.com.

In this episode, Pip and Rich chat to Dr Sue Pavord, current President of the British Society of Haematology. Over the last 18 months Dr Pavord has led from the front with serious work on defining liaison haematology, paving the way for this to be formally incorporated into haematologists' job plans. They also discuss Dr Pavord's pivotal role as a clinical leader in the UK's response to Vaccine Induced Immune Thrombosis with Thrombocytopenia (VITT). Her insight into medicine, politics, and strategy are invaluable and this is a wide ranging interview. Give it a listen, and give it a like! You can read the recent publication on Liaison Haematology, recently published in BMJ Open, here.

Pip and Rich preview their second Don't Just Read the Abstract newsletter. This week, the newsletter focuses on the work that the British Society for Haematology have being doing on workforce planning and liaison haematology in particular. If you would like to read Dr Sue Pavord's BSH message you can find it here.The paper we mention: Ransome et al. Defining ‘liaison haematology’ in the UK: a modified Delphi study. BMJ Open. 2025. To receive the newsletter, go to www.dontjustreadtheabstract.com and sign up. You can also access the newsletter on the website.

When Dr Peter Douglas listened to our episode on the PEERLESS trial (S1, Ep12), he began to develop a funny sensation in his chest.Emailing us he wrote:"Your commentary on this paper lead me to develop the signs and symptoms of submassive PE. I am an interventional radiologist who has spent the last 3-4 years setting up a PERT and catheter based therapy service for PE and would love to speak to you further about this. In a nutshell... you missed the point. But the point is not something the authors or sponsoring company were trying to prove, so you won't find it in the results section."Happily, he was joking (sort of), but it did make us want to get him on and ask him all about something we have limited personal experience of. So, we did!

In this 5 minute episode, Pip and Rich introduce the brand new Don't Just Read the Abstract Newsletter, a twice monthly update on all things medical haematology. Covering latest developments and publications in haemostasis, thrombosis, transfusion, immunohaematology, and red cell haematology, the newsletter will keep you up-to-date on what matters to patients.Sign up at www.dontjustreadtheabstract.com.

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.

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,

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.