Oral Rivaroxaban for the Treatment of Symptomatic Venous Thromboembolism in 400 Patients With Active Cancer: A Single-Center Experience

Pignataro, Bruno Soriano; Nishinari, Kenji; Cavalcante, Rafael; Centofanti, Guilherme; Yazbek, Guilherme; Krutman, Mariana; Bomfim, Guilherme Andre Zotelle; Fonseca, Igor Yoshio Imagawa; Teivelis, Marcelo Passos; Wolosker, Nelson; Sanches, Solange Moraes; Ramacciotti, Eduardo

doi:10.1177/1076029616677800

Cited by 27 publications

(17 citation statements)

References 21 publications

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“…15 Nonetheless, several noncontrolled prospective and retrospective cohort studies provided further support for DOACs as attractive alternatives to LMWHs in terms of efficacy and safety clinical outcomes in CT patients. 16 17 18 19 20…”

Section: Introductionmentioning

confidence: 99%

Treatment of Cancer-Associated Thrombosis: Beyond HOKUSAI

Mahé

Elalamy

Gerotziafas

et al. 2019

TH Open

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Direct oral anticoagulants (DOACs) represent an attractive alternative to low-molecular-weight heparins (LMWHs) for the long-term treatment of cancer-associated thrombosis (CT) since they avoid the burden of daily injections. Analyses in subgroups of cancer patients from large randomized trials suggested that DOACs were at least as effective as vitamin K antagonists, while indirect comparisons suggested that DOACs' efficacy and safety profile were comparable to those of LMWHs. In the randomized controlled HOKUSAI-VTE Cancer study, currently the only completed phase III trial on DOACs in CT patients, edoxaban was shown noninferior to dalteparin on the composite primary endpoint of time to first recurrent venous thromboembolism or major bleeding during the 12 months after randomization. Study results suggest that both agents had comparable benefit/risk ratio in patients with CT. Even though this conclusion was valid from a strict statistical viewpoint, it was potentially misleading when interpreting benefit/risk ratios. Besides the obvious heterogeneity of the study population (e.g., 23% of patients no longer had cancer) and significantly different treatment durations between arms, secondary outcomes for efficacy were in favor of edoxaban for recurrent deep-vein thrombosis but not for recurrent pulmonary embolism, and major bleeding episodes were significantly more frequent in the edoxaban group, with an excess of gastrointestinal (GI) bleeding episodes observed mainly but not only in patients with GI cancers. More research is needed regarding specific patients' profiles, cancer types, and treatment period to better clarify the respective roles of DOACs and LMWHs in CT patients.

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Section: Introductionmentioning

confidence: 99%

Treatment of Cancer-Associated Thrombosis: Beyond HOKUSAI

Mahé

Elalamy

Gerotziafas

et al. 2019

TH Open

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“…The inclusion and exclusion of citations/articles identified through the systematic literature search are illustrated in Figure . A total of six studies evaluating rivaroxaban for the treatment of CAT and published between 2016 and 2017 were included in the analysis (Table ) . Of the six studies, three were prospective (one multicenter) and three were retrospective (one used administrative claims data).…”

Section: Resultsmentioning

confidence: 99%

“…A total of six studies evaluating rivaroxaban for the treatment of CAT and published between 2016 and 2017 were included in the analysis (Table 1). [16][17][18][19][20][21] Of the six studies, three were prospective (one multicenter) and three were retrospective (one used administrative claims data). Individual study sample sizes ranged from 41 to 949 patients.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta‐Analysis of Real‐World Studies Evaluating Rivaroxaban for Cancer‐Associated Venous Thrombosis

et al. 2018

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“…Despite this, the potential of the direct oral anticoagulants for CAT treatment was self-evident. Large, but uncontrolled and single centre series describing the successful use of direct oral anticoagulants for CAT treatment have started to become available [42,43]. A meta-analysis of the large, direct oral anticoagulant trials considering only included cancer patients (n=1132) indicated that the direct oral anticoagulants were at least as safe and effective as the conventional treatment for VTE in cancer patients [44].…”

Section: Direct Oral Anticoagulantsmentioning

confidence: 99%

Cancer-associated thrombosis: the when, how and why

et al. 2019

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Cancer-associated thrombosis (CAT) is a condition in which relevance has been increasingly recognised both for physicians that deal with venous thromboembolism (VTE) and for oncologists. It is currently estimated that the annual incidence of VTE in patients with cancer is 0.5% compared to 0.1% in the general population. Active cancer accounts for 20% of the overall incidence of VTE. Of note, VTE is the second most prevalent cause of death in cancer, second only to the progression of the disease, and cancer is the most prevalent cause of deaths in VTE patients. Nevertheless, CAT presents several peculiarities that distinguish it from other VTE, both in pathophysiology mechanisms, risk factors and especially in treatment, which need to be considered. CAT data will be reviewed in this review.

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Oral Rivaroxaban for the Treatment of Symptomatic Venous Thromboembolism in 400 Patients With Active Cancer: A Single-Center Experience

Abstract: Rivaroxaban can be an attractive alternative for the treatment of cancer-associated thrombosis.

Cited by 27 publications

References 21 publications

Treatment of Cancer-Associated Thrombosis: Beyond HOKUSAI

Treatment of Cancer-Associated Thrombosis: Beyond HOKUSAI

Systematic Review and Meta‐Analysis of Real‐World Studies Evaluating Rivaroxaban for Cancer‐Associated Venous Thrombosis

Cancer-associated thrombosis: the when, how and why

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