Comparison of direct oral anticoagulants versus low-molecular-weight heparin in primary and metastatic brain cancers: a meta-analysis and systematic review.

anticoagulation brain cancer direct-acting oral anticoagulants intracranial hemorrhage venous thromboembolism

Journal

Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508

Informations de publication

Date de publication:
21 Oct 2023
Historique:
received: 31 07 2023
revised: 05 10 2023
accepted: 09 10 2023
pubmed: 23 10 2023
medline: 23 10 2023
entrez: 22 10 2023
Statut: aheadofprint

Résumé

The safety and efficacy of direct-acting oral anticoagulants (DOACs) for therapeutic anticoagulation in the setting of primary or metastatic brain cancer is not known. To conduct a meta-analysis and systematic review of studies that compare the risk of intracranial hemorrhage (ICH) in patients with brain cancer treated with DOACs vs low-molecular-weight heparin (LMWH). A literature search was conducted using PubMed, EMBASE, and Cochrane databases. Summary statistics were obtained by calculating the risk ratio (RR), and heterogeneity across studies was estimated using the I The pooled RR for ICH in patients receiving DOACs vs those receiving LMWH was 0.65 (95% CI, 0.36-1.17; P = .15; I The risk of ICH in patients with brain cancer receiving therapeutic anticoagulation varies by anticoagulation agent and diagnosis of primary or metastatic disease.

Sections du résumé

BACKGROUND BACKGROUND
The safety and efficacy of direct-acting oral anticoagulants (DOACs) for therapeutic anticoagulation in the setting of primary or metastatic brain cancer is not known.
OBJECTIVES OBJECTIVE
To conduct a meta-analysis and systematic review of studies that compare the risk of intracranial hemorrhage (ICH) in patients with brain cancer treated with DOACs vs low-molecular-weight heparin (LMWH).
METHODS METHODS
A literature search was conducted using PubMed, EMBASE, and Cochrane databases. Summary statistics were obtained by calculating the risk ratio (RR), and heterogeneity across studies was estimated using the I
RESULTS RESULTS
The pooled RR for ICH in patients receiving DOACs vs those receiving LMWH was 0.65 (95% CI, 0.36-1.17; P = .15; I
CONCLUSION CONCLUSIONS
The risk of ICH in patients with brain cancer receiving therapeutic anticoagulation varies by anticoagulation agent and diagnosis of primary or metastatic disease.

Identifiants

pubmed: 37866517
pii: S1538-7836(23)00779-1
doi: 10.1016/j.jtha.2023.10.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interests A.L. reports advisory board honorariums from Pfizer, Bayer, Sanofi, and Novartis. B.J.C. reports funding from Sanofi. J.I.Z. reports prior funding from Incyte and Quercegen and consultancy for Sanofi, CSL Behring, and Calyx. V.I., S.A., T.C., K.T., M.M., and R.P. report no conflicts of interest.

Auteurs

Varun Iyengar (V)

Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Shubham Agrawal (S)

Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania, USA.

Thita Chiasakul (T)

Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Kian Tehranchi (K)

Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Megan Mcnichol (M)

Division of Knowledge Services, Department of Information Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Brian J Carney (BJ)

Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Avi Leader (A)

Institiute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Jeffrey I Zwicker (JI)

Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA.

Rushad Patell (R)

Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Electronic address: rpatell@bidmc.harvard.edu.

Classifications MeSH