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.
Resumen
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.
Por qué esto importa para la hirudoterapia
Este estudio intervencionista evalúa los desenlaces de pacientes oncológicos tratados con apixabán, un anticoagulante oral directo, por tromboembolia venosa (TEV), midiendo las tasas de TEV recurrente, hemorragia y trombosis arterial durante seis meses. Los resultados indican que las frecuencias de TEV recurrente y hemorragia mayor concuerdan con la literatura existente, aunque la trombosis arterial surgió como un evento adverso grave frecuente. Si bien el estudio aborda la inhibición sistémica de los factores de la coagulación —un proceso modulado por las secreciones de la sanguijuela—, no existe un vínculo defendible con la hirudoterapia. El resumen no menciona sanguijuelas, extractos de sanguijuela ni terapias biológicas comparativas. Su relevancia para ASH es insignificante, ya que evalúa estrictamente un inhibidor sintético del factor Xa en una cohorte oncológica.
Citación
Thrombosis and bleedings in a cohort of cancer patients treated with apixaban for venous thromboembolism.
Hannevik et al. · Thrombosis research, 2020
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026