TY - JOUR
T1 - Use of direct oral anticoagulants and low molecular weight heparin in venous thromboembolism associated with cancer
T2 - real-world evidence in Argentina
AU - Clavijo, M. M.
AU - Ruiz, J. I.
AU - Muñoz, C.
AU - Vicente Reparaz M de Los, A.
AU - Acuña, M. A.
AU - Casali, C. E.
AU - Aizpurua, M. F.
AU - Mahuad, C. V.
AU - Zerga, M. E.
AU - Ventura, A.
AU - Garate, G. M.
N1 - Publisher Copyright:
© 2023 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Background: Venous thromboembolism (VTE) and major bleeding (MB) are common in cancer patients. Reduced-doses of antithrombotics as secondary prophylaxis have limited data. This work aims to describe and to compare treatments and outcomes for cancer-associated VTE. Research design and methods: Retrospective study. Adults with cancer-associated VTE were included. After 3–6 months of full-doses of anticoagulants, three strategies were considered: A) lowering the doses; B) maintaining full-doses; C) stopping treatment. The strategy and medication used were shown in a descriptive analysis and the rate of bleeding and VTE-recurrence between those in a comparative analysis. Results: A total of 420 patients were included, 56.2% received DOACs, 43.8% enoxaparin. Strategy was defined in 257 patients: A (50.2%), B (46.3%), and C (3.5%). Forty-one (9.8%) had VTE-recurrence and 15 (3.6%) had MB or clinically relevant non-major bleeding (CRNMB). According to strategy, recurrent-VTE was 8.5% (A), 4.2% (B), and 11.1 (C) (p = 0.22), MB or CRNMB was 0.8% (A), 1.7% (B), and 0% (C) (p = 0.64). Conclusions: DOACs and strategy A were the most frequently used agent and strategy, respectively. There were no differences between medications or strategies used. The results must be interpreted with caution, and it is a retrospective single-center study, probably with information and selection bias.
AB - Background: Venous thromboembolism (VTE) and major bleeding (MB) are common in cancer patients. Reduced-doses of antithrombotics as secondary prophylaxis have limited data. This work aims to describe and to compare treatments and outcomes for cancer-associated VTE. Research design and methods: Retrospective study. Adults with cancer-associated VTE were included. After 3–6 months of full-doses of anticoagulants, three strategies were considered: A) lowering the doses; B) maintaining full-doses; C) stopping treatment. The strategy and medication used were shown in a descriptive analysis and the rate of bleeding and VTE-recurrence between those in a comparative analysis. Results: A total of 420 patients were included, 56.2% received DOACs, 43.8% enoxaparin. Strategy was defined in 257 patients: A (50.2%), B (46.3%), and C (3.5%). Forty-one (9.8%) had VTE-recurrence and 15 (3.6%) had MB or clinically relevant non-major bleeding (CRNMB). According to strategy, recurrent-VTE was 8.5% (A), 4.2% (B), and 11.1 (C) (p = 0.22), MB or CRNMB was 0.8% (A), 1.7% (B), and 0% (C) (p = 0.64). Conclusions: DOACs and strategy A were the most frequently used agent and strategy, respectively. There were no differences between medications or strategies used. The results must be interpreted with caution, and it is a retrospective single-center study, probably with information and selection bias.
KW - anticoagulation
KW - cancer
KW - cancer associated thrombosis
KW - deep vein thrombosis
KW - direct oral anticoagulant
KW - enoxaparin thromboembolism
KW - pulmonary thromboembolism
KW - Thrombosis
KW - venous thromboembolism
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U2 - 10.1080/17474086.2023.2281945
DO - 10.1080/17474086.2023.2281945
M3 - Article
C2 - 37955142
AN - SCOPUS:85177029351
SN - 1747-4086
VL - 16
SP - 1143
EP - 1149
JO - Expert review of hematology
JF - Expert review of hematology
IS - 12
ER -