Comparison Between Non–vitamin K Antagonist Oral Anticoagulants and Low-Molecular-Weight Heparin in Asian Individuals With Cancer-Associated Venous Thromboembolism

Chen, Dong‐Yi; Tseng, Chi-Nan; Hsieh, Ming‐Jer; Lan, Wen-Ching; Chuang, Cheng-Keng; Pang, See‐Tong; Chen, Shaowei; Chen, Tien-Hsing; Chang, Shang‐Hung; Hsieh, I‐Chang; Chu, Pao‐Hsien; Wen, Ming‐Shien; Chen, Jen‐Shi; Chang, John Wen‐Cheng; See, Lai‐Chu; Huang, Wen-Kuan

doi:10.1001/jamanetworkopen.2020.36304

Cited by 27 publications

(76 citation statements)

References 32 publications

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“…In this study, the majority of patients were female (66.2%). These findings seem to be interesting since other studies showed similar percentages of male and female patients (Young et al, 2018;Faqah et al, 2020;Chen et al, 2021). Countless risk factors for CAT have been narrated well in literature (Ay et al, 2017;Abdol Razak et al, 2018).…”

Section: Discussionsupporting

confidence: 73%

Efficacy of Rivaroxaban Use in Solid Tumour Malignancy: Experience from a Tertiary Care Cancer Centre

Ahmat

Puteh

Yusak

2021

Asian Pac J Cancer Prev

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Section: Discussionsupporting

confidence: 73%

Efficacy of Rivaroxaban Use in Solid Tumour Malignancy: Experience from a Tertiary Care Cancer Centre

Ahmat

Puteh

Yusak

2021

Asian Pac J Cancer Prev

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“…MB events are very burdensome and frequently severely disabling, leading to low QALYs despite it is modest decrease. Recent studies found that DOACs may be associated with low MB events for the treatment of cancer-associated VTE in Asian patients than in non-Asian patients [ 56 ]. Furthermore, a significant decrease in GI bleeding risk was observed with DOACs [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies found that DOACs may be associated with low MB events for the treatment of cancer-associated VTE in Asian patients than in non-Asian patients [ 56 ]. Furthermore, a significant decrease in GI bleeding risk was observed with DOACs [ 56 ]. So DOACs can be a more cost-effective treatment compared to LMWHs in Chinese patients with CAT.…”

Section: Discussionmentioning

confidence: 99%

Direct oral anticoagulants versus low molecular weight heparins for the treatment of cancer-associated thrombosis: a cost-effectiveness analysis

Wumaier

Chen

et al. 2021

Thrombosis J

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Background Recently, direct oral anticoagulants (DOACs) have been included in guidelines for the treatment of cancer-associated thrombosis (CAT) to be extended to suitable cancer patients. The purpose of this study was to compare the cost-effectiveness of using DOACs and low molecular weight heparins (LMWHs) for treating CAT from the perspective of the Chinese healthcare system. Methods A Markov model was constructed to estimate the cost-effectiveness of the two strategies with a 6-month and 5-year time horizon. Input parameters were either sourced from the clinical trial, published literature. The primary outcome of the model was reported as incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to test model uncertainty. Results The 6-month cost of DOACs was $ 654.65 with 0.40 quality adjusted life-years (QALYs) while the 6-month cost of LMWHs was $USD 1719.31 with 0.37 QALYs. Similarly, treatment with DOACs had a lower cost ($USD 657.85 vs. $USD 1716.56) and more health benefits (0.40 QALYs vs. 0.37 QALYs) than treatment with LMWHs in a subgroup of patients with gastrointestinal malignancy. We found treatment with DOACs would result in a large reduction in cost ($USD 1447.22 vs. $USD 3374.70) but a small reduction in QALYs (3.07 QALYs vs. 3.09 QALYs) compared with LMWHs over a 5-year time frame, resulting in an ICER of $USD 112895.50/QALYs. Sensitivity analysis confirmed the robustness of the results. Conclusion As compared to LMWHs, DOACs can be a cost-saving anticoagulant choice for the treatment of CAT in the general oncology population and gastrointestinal malignancy population.

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“…This study analyzed data from the Chang Gung Research Database (CGRD), which is a multi-institutional medical records database of the CGMH system [ 6 , 7 ]. The CGMH system has been described previously [8] . In brief, it includes seven branches (four tertiary academic medical centers and three teaching hospitals) across Taiwan, with a total of 10,050 beds and 2.4 million hospitalizations every year.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study

Chen

Tseng

et al. 2021

eClinicalMedicine

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Background: The effectiveness and safety of initiating sacubitril/valsartan therapy among patients who are hospitalized for acute heart failure (HF) is unclear. Methods: A cohort of 3736 patients with HF with reduced ejection fraction (HFrEF) hospitalized for acute HF was identified from Chang Gung Research Database between January 1, 2016 and August 31, 2019. The risks of rehospitalization for HF and death associated with sacubitril/valsartan therapy compared to angiotensinconverting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy were evaluated. We used stabilized inverse probability of treatment weighting to balance the baseline covariates. The risks of fatal and non-fatal outcomes between the groups were compared using a Cox proportional hazard model and Fine and Gray subdistribution hazard model, respectively. Findings: The composite of rehospitalization for HF and death occurred in 22.9% of the patients in the sacubitril/valsartan group compared to 32.6% in the ACEI/ARB group (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.52À0.97) after a mean follow-up period of 11.8 months. The sacubitril/valsartan group had a lower risk of rehospitalization for HF (subdistribution HR 0.83, 95% CI 0.74À0.92) and all-cause death (HR 0.51, 95% CI 0.27À0.94). There were no significant differences in the rates of worsening renal function or severe hyperkalemia between the two groups. Interpretation: In real-world practice, initiating sacubitril/valsartan therapy among patients with HFrEF who were hospitalized for acute HF was associated with a lower rate of rehospitalization for HF and death compared with ACEI/ARB therapy.

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Comparison Between Non–vitamin K Antagonist Oral Anticoagulants and Low-Molecular-Weight Heparin in Asian Individuals With Cancer-Associated Venous Thromboembolism

Abstract: This cohort study compares the risks of venous thromboembolism (VTE) recurrence in patients receiving non–vitamin K antagonist oral anticoagulants (NOACs) vs low-molecular-weight heparin in Asian individuals with cancer.

Cited by 27 publications

References 32 publications

Efficacy of Rivaroxaban Use in Solid Tumour Malignancy: Experience from a Tertiary Care Cancer Centre

Efficacy of Rivaroxaban Use in Solid Tumour Malignancy: Experience from a Tertiary Care Cancer Centre

Direct oral anticoagulants versus low molecular weight heparins for the treatment of cancer-associated thrombosis: a cost-effectiveness analysis

Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study

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