Rivaroxaban
Aged
Aged, 80 and over
Digestive System Neoplasms
/ complications
Female
Hemorrhage
/ diagnosis
Heparin, Low-Molecular-Weight
/ administration & dosage
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Prognosis
Rivaroxaban
/ administration & dosage
Treatment Outcome
Venous Thromboembolism
/ diagnosis
Rivaroxaban
gastrointestinal tract cancer
hepatopancreatobiliary cancer
low-molecular-weight heparin
venous thromboembolism
Journal
In vivo (Athens, Greece)
ISSN: 1791-7549
Titre abrégé: In Vivo
Pays: Greece
ID NLM: 8806809
Informations de publication
Date de publication:
Historique:
received:
24
12
2019
revised:
05
01
2020
accepted:
06
01
2020
entrez:
1
3
2020
pubmed:
1
3
2020
medline:
15
12
2020
Statut:
ppublish
Résumé
The aim of this study was to examine the efficacy and safety of direct oral anticoagulants for cancer-associated venous thromboembolism (VTE) in patients with active cancer. This study included patients with advanced unresectable/metastatic upper gastrointestinal (GI) or hepatopancreatobiliary (HPB) cancers with high risks of VTE and bleeding. No significant differences were noted in potential bleeding factors between the rivaroxaban (n=105) and low-molecular-weight heparin (LMWH) (n=69) groups. Rivaroxaban exhibited similar risk of recurrent/aggravated VTE compared with LMWH (p=0.625) but increased risk of major bleeding (17.4% vs. 7.6%; p=0.072), clinically relevant bleeding (31.9% vs. 14.3%; p=0.019), and total bleeding (40.6% vs. 19%; p=0.010). The multivariate analysis regarded rivaroxaban as a significant factor for major bleeding (p=0.043) and clinically relevant bleeding (p=0.043). Rivaroxaban exhibits comparable efficacy but increases bleeding risks compared with LMWH in patients with active unresectable/metastatic upper GI tract or HPB cancers, requiring extra caution of higher major bleeding risks.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
The aim of this study was to examine the efficacy and safety of direct oral anticoagulants for cancer-associated venous thromboembolism (VTE) in patients with active cancer.
PATIENTS AND METHODS
METHODS
This study included patients with advanced unresectable/metastatic upper gastrointestinal (GI) or hepatopancreatobiliary (HPB) cancers with high risks of VTE and bleeding.
RESULTS
RESULTS
No significant differences were noted in potential bleeding factors between the rivaroxaban (n=105) and low-molecular-weight heparin (LMWH) (n=69) groups. Rivaroxaban exhibited similar risk of recurrent/aggravated VTE compared with LMWH (p=0.625) but increased risk of major bleeding (17.4% vs. 7.6%; p=0.072), clinically relevant bleeding (31.9% vs. 14.3%; p=0.019), and total bleeding (40.6% vs. 19%; p=0.010). The multivariate analysis regarded rivaroxaban as a significant factor for major bleeding (p=0.043) and clinically relevant bleeding (p=0.043).
CONCLUSION
CONCLUSIONS
Rivaroxaban exhibits comparable efficacy but increases bleeding risks compared with LMWH in patients with active unresectable/metastatic upper GI tract or HPB cancers, requiring extra caution of higher major bleeding risks.
Identifiants
pubmed: 32111791
pii: 34/2/829
doi: 10.21873/invivo.11845
pmc: PMC7157862
doi:
Substances chimiques
Heparin, Low-Molecular-Weight
0
Rivaroxaban
9NDF7JZ4M3
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
829-837Informations de copyright
Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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