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.
Summary
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.
Why This Matters for Hirudotherapy
This interventional study evaluates the outcomes of cancer patients treated with apixaban, a direct oral anticoagulant, for venous thromboembolism (VTE), measuring recurrent VTE, bleeding, and arterial thrombosis rates over six months. The results indicate that recurrent VTE and major bleeding frequencies align with existing literature, though arterial thrombosis emerged as a frequent serious adverse event. While the study addresses the systemic inhibition of coagulation factors—a process modulated by leech secretions—there is no defensible link to hirudotherapy. The abstract does not mention leeches, leech extracts, or comparative biological therapies. Its relevance to ASH is negligible, as it strictly evaluates a synthetic factor Xa inhibitor in an oncology cohort.
Citation
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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