Long-term use of tinzaparin for the treatment of cancer-associated thrombosis in clinical practice: Insights from the prospective TROPIQUE study.

Heparin, Low-Molecular-Weight / adverse effects Humans Neoplasms / complications Prospective Studies Thrombosis / drug therapy Tinzaparin / adverse effects Venous Thromboembolism / diagnosis
Cancer Clinical practice guidelines Tinzaparin Venous thromboembolism

Journal

Journal de medecine vasculaire
ISSN: 2542-4513
Titre abrégé: J Med Vasc
Pays: France
ID NLM: 101709200

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 25 02 2022
accepted: 28 03 2022
entrez: 12 6 2022
pubmed: 13 6 2022
medline: 15 6 2022
Statut: ppublish

Résumé

Real word data on the efficacy and safety of long-term use of tinzaparin for the treatment of cancer-associated thrombosis (CAT) are scarce. We performed a post-hoc analysis of all cancer patients included in the prospective multicenter observational TROPIQUE study who received long-term treatment with tinzaparin for a first venous thromboembolism (VTE) event. We evaluated the patterns of anticoagulant prescription, the adherence to clinical practice guidelines (CPGs) for the treatment of CAT, and the clinical outcomes within a 6-month follow-up. In total, 301 patients were included in this post-hoc analysis. At study entry, their mean age was 64.6±11.9years and 143 (47.5%) patients were men. The most frequent cancer type was gastrointestinal (23.9%), followed by breast (17.9%) and lung (15.3%) cancer. At time of VTE diagnosis, 164 (57.8%) patients had metastatic disease and 245 (81.42%) were receiving chemotherapy. Based on the aggregation of all study pre-defined criteria, tinzaparin prescription was fully compliant with CPGs in 219 (72.8%) patients. The mean effective treatment duration with tinzaparin was 6.07±0.17months. At 6-month follow-up, the cumulative incidence of recurrent VTE was 5.4% (95% CI: 3.2-9.2%) and the cumulative incidence of major bleeding was 5.8% (95% CI: 3.6-9.6%). Clinical outcomes tended to differ across different types of cancer. Death from any cause occurred in 102 (33.9%) patients, mainly related to cancer progression. This post-hoc analysis of TROPIQUE confirms the favorable benefit-risk ratio of tinzaparin for the long-term treatment of CAT.

Sections du résumé

BACKGROUND BACKGROUND
Real word data on the efficacy and safety of long-term use of tinzaparin for the treatment of cancer-associated thrombosis (CAT) are scarce.
METHODS METHODS
We performed a post-hoc analysis of all cancer patients included in the prospective multicenter observational TROPIQUE study who received long-term treatment with tinzaparin for a first venous thromboembolism (VTE) event. We evaluated the patterns of anticoagulant prescription, the adherence to clinical practice guidelines (CPGs) for the treatment of CAT, and the clinical outcomes within a 6-month follow-up.
RESULTS RESULTS
In total, 301 patients were included in this post-hoc analysis. At study entry, their mean age was 64.6±11.9years and 143 (47.5%) patients were men. The most frequent cancer type was gastrointestinal (23.9%), followed by breast (17.9%) and lung (15.3%) cancer. At time of VTE diagnosis, 164 (57.8%) patients had metastatic disease and 245 (81.42%) were receiving chemotherapy. Based on the aggregation of all study pre-defined criteria, tinzaparin prescription was fully compliant with CPGs in 219 (72.8%) patients. The mean effective treatment duration with tinzaparin was 6.07±0.17months. At 6-month follow-up, the cumulative incidence of recurrent VTE was 5.4% (95% CI: 3.2-9.2%) and the cumulative incidence of major bleeding was 5.8% (95% CI: 3.6-9.6%). Clinical outcomes tended to differ across different types of cancer. Death from any cause occurred in 102 (33.9%) patients, mainly related to cancer progression.
CONCLUSIONS CONCLUSIONS
This post-hoc analysis of TROPIQUE confirms the favorable benefit-risk ratio of tinzaparin for the long-term treatment of CAT.

Identifiants

DOI: 10.1016/j.jdmv.2022.04.004 PMID: 35691664
pubmed: 35691664
pii: S2542-4513(22)00187-0
doi: 10.1016/j.jdmv.2022.04.004
pii:
doi:

Substances chimiques

Heparin, Low-Molecular-Weight 0
Tinzaparin 7UQ7X4Y489

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

56-64

Informations de copyright

Copyright © 2022 Elsevier Masson SAS. All rights reserved.

Auteurs

C Frere (C)

INSERM UMRS-1166, Institute of Cardiometabolism and Nutrition, GRC 27 GRECO, Sorbonne Université, DMU BioGem, Pitié-Salpêtrière Hospital, Assistance publique-Hôpitaux de Paris, 75013 Paris, France; Groupe Francophone Thrombose et Cancer, 75015 Paris, France. Electronic address: corinne.frere@aphp.fr.

B Crichi (B)

Groupe Francophone Thrombose et Cancer, 75015 Paris, France; Internal Medicine Unit (UF 04): CRMR MATHEC, Maladies Auto-immunes et Thérapie Cellulaire, Saint-Louis Hospital, Assistance publique-Hôpitaux de Paris, 75010 Paris, France.

J A Rueda-Camino (JA)

Groupe Francophone Thrombose et Cancer, 75015 Paris, France; Department of Internal Medicine, Hospital Rey Juan Carlos, Madrid, Spain.

F Cajfinger (F)

Groupe Francophone Thrombose et Cancer, 75015 Paris, France; Department of Medical Oncology, Pitié-Salpêtrière Hospital, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.

N Spiess (N)

LEO Pharma, 78960 Voisin-le-Bretonneux, France.

N Janus (N)

LEO Pharma, 78960 Voisin-le-Bretonneux, France.

C Le Maignan (C)

Groupe Francophone Thrombose et Cancer, 75015 Paris, France; Department of Internal Medicine, Hospital Rey Juan Carlos, Madrid, Spain.

Z Marjanovic (Z)

Groupe Francophone Thrombose et Cancer, 75015 Paris, France; Department of Hematology, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 75010 Paris, France.

D Farge (D)

Groupe Francophone Thrombose et Cancer, 75015 Paris, France; Internal Medicine Unit (UF 04): CRMR MATHEC, Maladies Auto-immunes et Thérapie Cellulaire, Saint-Louis Hospital, Assistance publique-Hôpitaux de Paris, 75010 Paris, France; Université de Paris, Institut Universitaire d'Hématologie, EA 3518, 75010 Paris, France.

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Classifications MeSH

questionsmedicales.fr › Glucides › Polyosides › Glycosaminoglycanes › Héparine › Héparine bas poids moléculaire › Long-term use of tinzaparin for the treatment...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Long-term use of tinzaparin for the treatment...
questionsmedicales.fr › Tumeurs › Long-term use of tinzaparin for the treatment...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Long-term use of tinzaparin for the treatment...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thrombose › Long-term use of tinzaparin for the treatment...
questionsmedicales.fr › Glucides › Polyosides › Glycosaminoglycanes › Héparine › Héparine bas poids moléculaire › Tinzaparine › Long-term use of tinzaparin for the treatment...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thromboembolie › Thromboembolisme veineux › Long-term use of tinzaparin for the treatment...