Edoxaban for treatment of venous thromboembolism in patient groups with different types of cancer: Results from the Hokusai VTE Cancer study.

Anticoagulants / adverse effects Humans Neoplasm Recurrence, Local Pyridines Thiazoles / adverse effects Venous Thromboembolism / drug therapy
Anticoagulant Cancer-associated venous thromboembolism Dalteparin Direct oral anticoagulant Edoxaban Neoplasms Pulmonary embolism Thrombosis Venous thromboembolism

Journal

Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377

Informations de publication

Date de publication:
01 2020
Historique:
received: 02 04 2019
revised: 06 11 2019
accepted: 07 11 2019
pubmed: 17 11 2019
medline: 22 6 2021
entrez: 17 11 2019
Statut: ppublish

Résumé

The safety and efficacy of edoxaban and dalteparin is unclear for several cancer groups. We evaluated the occurrence of the primary outcome in large cancer groups. The primary outcome was the composite of recurrent VTE or major bleeding over 12 months. In patients with gastrointestinal cancer, the primary outcome occurred in 19.4% patients given edoxaban and in 15.0% given dalteparin (risk difference [RD], 4.4%; 95%-CI, -4.1% to 12.8%). The corresponding rates for edoxaban and dalteparin were 10.4% and 10.7% for lung cancer (RD, -0.3%; 95%-CI, -10.0% to 9.5%), 13.6% and 12.5% for urogenital cancer (RD, 1.1; 95%-CI, -10.1-12.4), 3.1% and 11.7% for breast cancer (RD, -8.6; 95%-CI, -19.3-2.2), 8.9% and 10.9% for hematological malignancies (RD, -2.0; 95%-CI, -13.1-9.1), and 10.4% and 17.4% for gynecological cancer (RD, -7.0; 95%-CI, -19.8-5.7). In the subgroup of gastrointestinal cancer, edoxaban was associated with a 3.5% lower absolute risk of recurrent VTE and a 7.9% higher risk of major bleeding. Edoxaban has a similar risk-benefit ratio to dalteparin in most cancer groups. In those with gastrointestinal cancer, the lower risk of recurrent VTE and the advantages of oral therapy need to be balanced against the increased risk of major bleeding.

Sections du résumé

BACKGROUND
The safety and efficacy of edoxaban and dalteparin is unclear for several cancer groups.
METHODS
We evaluated the occurrence of the primary outcome in large cancer groups. The primary outcome was the composite of recurrent VTE or major bleeding over 12 months.
RESULTS
In patients with gastrointestinal cancer, the primary outcome occurred in 19.4% patients given edoxaban and in 15.0% given dalteparin (risk difference [RD], 4.4%; 95%-CI, -4.1% to 12.8%). The corresponding rates for edoxaban and dalteparin were 10.4% and 10.7% for lung cancer (RD, -0.3%; 95%-CI, -10.0% to 9.5%), 13.6% and 12.5% for urogenital cancer (RD, 1.1; 95%-CI, -10.1-12.4), 3.1% and 11.7% for breast cancer (RD, -8.6; 95%-CI, -19.3-2.2), 8.9% and 10.9% for hematological malignancies (RD, -2.0; 95%-CI, -13.1-9.1), and 10.4% and 17.4% for gynecological cancer (RD, -7.0; 95%-CI, -19.8-5.7). In the subgroup of gastrointestinal cancer, edoxaban was associated with a 3.5% lower absolute risk of recurrent VTE and a 7.9% higher risk of major bleeding.
CONCLUSION
Edoxaban has a similar risk-benefit ratio to dalteparin in most cancer groups. In those with gastrointestinal cancer, the lower risk of recurrent VTE and the advantages of oral therapy need to be balanced against the increased risk of major bleeding.

Identifiants

DOI: 10.1016/j.thromres.2019.11.007 PMID: 31733403
pubmed: 31733403
pii: S0049-3848(19)30493-1
doi: 10.1016/j.thromres.2019.11.007
pii:
doi:

Substances chimiques

Anticoagulants 0
Pyridines 0
Thiazoles 0
edoxaban NDU3J18APO

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

13-19

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2019. Published by Elsevier Ltd.

Auteurs

F I Mulder (FI)

Department of Vascular Medicine, Amsterdam Cardiovascular Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: f.i.mulder@amsterdamumc.nl.

N van Es (N)

Department of Vascular Medicine, Amsterdam Cardiovascular Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

N Kraaijpoel (N)

Department of Vascular Medicine, Amsterdam Cardiovascular Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

M Di Nisio (M)

Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti, Italy.

M Carrier (M)

Ottawa Hospital Research Institute, Ottawa, Canada.

A Duggal (A)

Daiichi Sankyo Pharma Development, Basking Ridge, NJ, USA.

M Gaddh (M)

Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, USA.

D Garcia (D)

Department of Medicine, Division of Hematology, University of Washington, Seattle, USA.

M A Grosso (MA)

Daiichi Sankyo Pharma Development, Basking Ridge, NJ, USA.

A K Kakkar (AK)

Thrombosis Research Institute, University College London, London, United Kingdom.

M F Mercuri (MF)

Daiichi Sankyo Pharma Development, Basking Ridge, NJ, USA.

S Middeldorp (S)

Department of Vascular Medicine, Amsterdam Cardiovascular Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

G Royle (G)

Department of Hematology, Middlemore Hospital, Auckland, New Zealand.

A Segers (A)

ITREAS, Academic Research Organization, Amsterdam, the Netherlands.

S Shivakumar (S)

Department of Hematology, Queen Elizabeth II Health Sciences Centre, Halifax, Canada.

P Verhamme (P)

Department of Vascular Medicine and Hemostasis, University Hospitals Leuven, Leuven, Belgium.

T Wang (T)

Department of Internal Medicine, Division of Hematology, The Ohio State University Wexner Medical Center, Columbus, USA.

J I Weitz (JI)

McMaster University, The Thrombosis and Atherosclerosis Research Institute, Hamilton, Canada.

G Zhang (G)

Daiichi Sankyo Pharma Development, Basking Ridge, NJ, USA.

H R Büller (HR)

Department of Vascular Medicine, Amsterdam Cardiovascular Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

G Raskob (G)

University of Oklahoma Health Sciences Center, College of Public Health, Oklahoma City, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Anticoagulants › Edoxaban for treatment of venous...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Edoxaban for treatment of venous...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Edoxaban for treatment of venous...
questionsmedicales.fr › Composés hétérocycliques › Composés hétéromonocycliques › Pyridines › Edoxaban for treatment of venous...
questionsmedicales.fr › Composés hétérocycliques › Composés hétéromonocycliques › Azoles › Thiazoles › Edoxaban for treatment of venous...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thromboembolie › Thromboembolisme veineux › Edoxaban for treatment of venous...