An oral anticoagulant has proved effective as a treatment for cancer patients with venous thromboembolism, researchers have reported.
Professor Annie Young of the University of Warwick, UK, and colleagues set out to see whether an oral anticoagulant, rivaroxaban, could be an effective alternative treatment to daily injections of low-molecular-weight heparin.
They recruited 406 patients with active cancer who had pulmonary embolism or deep vein thrombosis, and gave them either the low-molecular-weight heparin dalteparin or rivaroxaban.
Over the next six months, fewer patients on rivaroxaban experienced recurrent venous thromboembolism than those on dalteparin (4% versus 11%). The rates of major bleeding over this time were similar in both groups - 6% for rivaroxaban and 4% for dalteparin.
However, the rate of clinically relevant non-major bleeding was 4% on dalteparin, but 13% on rivaroxaban. Full details are published in The Journal of Clinical Oncology.
Professor Young said: "Clinicians were already adopting the oral drug into practice for non-cancer patients and now they have data from this study to indicate that this form of treatment is an alternative option for many cancer patients who have a clot.
"We now need to be sitting down with each one of our cancer patients with venous thromboembolism, discussing their preference alongside looking at all their clinical details including whether the cancer lesion is still there, what other medications are being taken and what other conditions the patient has so that we can choose the optimal venous thromboembolism treatment for each patient."
Source: Young, A.M., Marshall, A., Thirlwall, J., Chapman, O., Lokare, A., Hill, C., Hale, D., Dunn, J.A., Lyman, G.H., Hutchinson, C. and MacCallum, P., 2018. Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D). Journal of Clinical Oncology, pp.JCO-2018.
Link: http://ascopubs.org/doi/abs/10.1200/JCO.2018.78.8034
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