Key result
~32% of DOAC-eligible cancer patients switch from LMWH to a DOAC within one year.
Why the study?
Pharmacokinetic drug-drug interactions are challenging aspects of DOAC therapy in patients with cancer.
What is the one-year cumulative incidence of switching from LMWH to DOACs in patients with cancer?
Cohort (n=161)
No
What is the one-year cumulative incidence of switching from LMWH to DOACs in patients with cancer?
In patients with cancer, the transition from LMWH to DOACs is infrequent (32% at one year), highlighting a potential area for improving anticoagulant therapy management.
Answers are grounded in this paper and cite their sources.
May signal barriers to DOAC adoption in cancer; hypothesis-generating for targeted implementation studies.
INTRODUCTION: Pharmacokinetic drug-drug interactions (DDIs) are challenging aspects of direct oral anticoagulant (DOAC) therapy in patients with cancer. We evaluated the prevalence of potential DOAC/antineoplastic agent DDIs and the one-year cumulative incidence of switching from low-molecular-weight heparin (LMWH) to a DOAC in patients with cancer. METHODS: Patients with cancer and an indication of LMWH were included from Herlev and Gentofte Hospital, Denmark, in the 2014-2019 period. Follow-up was initiated when the first dose of LMWH was dispensed. Data were obtained from electronic medical records. One-year cumulative incidence of switching from LMWH to DOAC was estimated using the Aalen-Johansen estimator. Potential DDIs were evaluated using a report from the European Heart Rhythm Association (EHRA) and a review by Hellfritzsch et al. RESULTS. A total of 161 patients were included with a median age of 70.8 (interquartile range: 64.2-76.1) years. The one-year cumulative incidence of switching from LMWH to DOAC was 32% (95% confidence intervals: 21-43%) in patients eligible for DOACs. Using the EHRA report, a total of 24% of antineoplastic agents were not identified. This percentage decreased to 8% using data from Hellfritzsch et al. CONCLUSIONS. In patients with cancer, the one-year cumulative incidence of switching from LMWH to DOAC was less-t 35% in patients eligible for DOAC, revealing a potential for improved anticoagulant treatment. Furthermore, contemporary data elaborated on potential DDIs between DOACs/antineoplastic agents. FUNDING: "Helsefonden" (21-B-0350) and the "Karen Elise Jensens Fonden" (29-4-2021) funded the study. TRIAL REGISTRATION: Not relevant.
No takes yet. Share an insight, caveat, or question.
Nouhravesh et al. (2024) conducted a cohort in Cancer-associated thrombosis (n=161). Direct oral anticoagulants (DOAC) vs. Low-molecular-weight heparin (LMWH) was evaluated on One-year cumulative incidence of switching from LMWH to DOAC (95% CI 21-43). In patients with cancer eligible for direct oral anticoagulants, the one-year cumulative incidence of switching from low-molecular-weight heparin to a direct oral anticoagulant was 32%.
Synapse has enriched 10 related papers. Consider them for comparative context: