Thrombosis and bleedings in a cohort of cancer patients treated with apixaban for venous thromboembolism.
Research article published in Thrombosis research (2020)
Abstract
INTRODUCTION: The direct oral anti-coagulants (DOAC) edoxaban and rivaroxaban are suggested treatment alternatives for cancer-associated venous thromboembolism (VTE) together with low molecular-weight heparins. New studies indicate that the DOAC apixaban also is an option for cancer-associated VTE. The current study assessed recurrent VTE, arterial thrombosis, bleedings and adverse events in a cohort of apixaban treated cancer patients with VTE. MATERIALS AND METHODS: Single-arm, interventional study of apixaban as treatment of cancer-associated VTE. Inclusion criteria were cancer with objectively verified VTE. Patients received apixaban 10 mg bid for seven days, then 5 mg bid for six months. Primary efficacy and safety outcomes were recurrent VTE and bleeding respectively. This trial is registered with ClinicalTrials.gov identifier NCT02581176. RESULTS: We recruited 298 cancer patients with VTE. During six months treatment, recurrent VTE or death related to VTE occurred in 12 patients (4.0%, 95% confidence interval (CI) 2.1-6.9%). Major bleeding occurred in 16 patients (5.4%, 95% CI 2.8-7.9), most frequently gastrointestinal bleeding. There were no overrepresentation of major bleedings among patients with gastrointestinal cancer (7/126, 5.5%, 95% CI 2.3-11%). Twenty-six patients experienced one or more clinically relevant non-major bleedings (8.9%, 95% CI 5.5-12%). Twelve patients had arterial thrombosis (4.0%, 95% CI 2.1-6.9%), of which the majority were strokes in patients with pancreatic cancer. Death occurred in 35 patients (12%, 95% CI 8.3-16%). CONCLUSION: The frequency of recurrent VTE and major bleedings are in line with other studies on apixaban in cancer-associated VTE. Arterial thrombosis was a frequent serious adverse event.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
The direct oral anti-coagulants (DOAC) edoxaban and rivaroxaban are suggested treatment alternatives for cancer-associated venous thromboembolism (VTE) together with low molecular-weight heparins. New studies indicate that the DOAC apixaban also is an option for cancer-associated VTE.
Warum dies für die Hirudotherapie relevant ist
Diese interventionelle Studie bewertet die Ergebnisse von Krebspatienten, die mit Apixaban, einem direkten oralen Antikoagulans, aufgrund venöser Thromboembolien (VTE) behandelt wurden, und misst über sechs Monate die Raten rezidivierender VTE, Blutungskomplikationen sowie arterieller Thrombosen. Die Ergebnisse zeigen, dass die Häufigkeiten rezidivierender VTE und schwerer Blutungen mit der bestehenden Literatur übereinstimmen, wobei arterielle Thrombosen als häufiges schwerwiegendes unerwünschtes Ereignis hervortraten. Obwohl die Studie die systemische Hemmung von Gerinnungsfaktoren adressiert – ein Prozess, der durch Blutegelsekrete moduliert wird –, lässt sich kein vertretbarer Zusammenhang mit Hirudotherapie herstellen. Das Abstract erwähnt weder Blutegel, Blutegelextrakte noch vergleichende biologische Therapien. Ihre Relevanz für ASH ist vernachlässigbar, da sie ausschließlich einen synthetischen Faktor-Xa-Inhibitor in einer onkologischen Kohorte evaluiert.
Zitation
Thrombosis and bleedings in a cohort of cancer patients treated with apixaban for venous thromboembolism.
Hannevik et al. · Thrombosis research, 2020
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