Low-molecular-weight heparins are superior to vitamin K antagonists for the long term treatment of venous thromboembolism in patients with cancer: a cochrane systematic review

Abstract

Background: Cancer and its therapies increase the risk of venous thromboembolism. Compared to patients without cancer, patients with cancer anticoagulated for venous thromboembolism are more likely to develop recurrent thrombotic events and major bleeding. Addressing all important outcomes including harm is of great importance to make evidence based health care decisions. The objective of this study was to compare low molecular weight heparin (LMWH) and oral anticoagulants (vitamin K antagonist (VKA) and ximelagatran) for the long term treatment of venous thromboembolism in patients with cancer.

Low molecular weight heparin tinzaparin antagonizes cisplatin resistance of ovarian cancer cells

“…The retrospective evaluation of clinical data indicated that heparin treatment can provide a survival benefit of patients with cancer in comparison to antithrombotic treatment using vitamin K antagonist (VKA) 5 . This finding was confirmed by a number of prospective clinical trials [6][7][8] .…”

Low-molecular-weight heparins for cancer-associated thrombosis: Adherence to clinical practice guidelines and patient perception in TROPIQUE, a 409-patient prospective observational study

“…More recently a trend towards a superior efficacy in reducing the relative risk of VTE recurrence was shown with the LMWH tinzaparin compared to VKA [19]. Despite the evidence [20][21][22], there are substantial reports from observational studies of insufficient adherence to established clinical practice guidelines [23][24][25][26][27]. Thrombosis Research 144 (2016) [85][86][87][88][89][90][91][92] Recent studies have shown that long-term LMWH were well accepted by patients and physicians tended to underestimate patients' ability to accept long-term treatment with LMWH [28].…”

Four Cases of Trousseau's Syndrome Associated with Lung Adenocarcinoma

“…In addition, thrombolytic therapy and thromboprophylaxis are necessary. Compared with vitamin K antagonist (VKA), heparin is reported to provide a statistically significant reduction in VTE (20). This is because heparin has several antithrombotic mechanisms that VKA does not, such as inhibition of the binding of mucin to selectin and release of tissue factor pathway inhibitor from endothelial binding sites (2).…”