Key result
Direct oral factor Xa inhibitors lowered the risk of VTE recurrence compared to dalteparin (OR 0.48; 95% CI 0.24-0.96) but increased major bleeding (OR 1.70; 95% CI 1.04-2.78).
Why the study?
The study was conducted to explore the efficacy and safety of direct oral factor Xa inhibitors compared with dalteparin, and to compare apixaban, rivaroxaban, and edoxaban in cancer-associated acute VTE.
Do direct oral factor Xa inhibitors reduce VTE recurrence compared to dalteparin in patients with cancer-associated acute VTE?
Population
1,739 patients with cancer associated VTE across three randomized controlled trials
Comparison
Direct oral factor Xa inhibitors (apixaban, rivaroxaban, edoxaban) vs dalteparin
Design
Systematic review and network meta-analysis
Authors
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May favor DOACs over dalteparin for recurrence prevention in cancer VTE despite bleeding risk; extends pooled RCT evidence.
Meta-Analysis (n=1,739)
Do direct oral factor Xa inhibitors reduce VTE recurrence compared to dalteparin in patients with cancer-associated acute VTE?
Effect estimate: OR 0.48 (95% CI 0.24-0.96)
In patients with cancer-associated acute VTE, direct oral factor Xa inhibitors reduce VTE recurrence but increase major bleeding compared to dalteparin, with apixaban potentially offering the greatest reduction in recurrence.
Fuentes et al. (2019) conducted a meta-analysis in cancer associated acute venous thromboembolism (VTE) (n=1,739). Direct oral factor Xa inhibitors (DOACs) vs. dalteparin was evaluated on VTE recurrence (OR 0.48, 95% CI 0.24-0.96). Direct oral factor Xa inhibitors lowered the risk of VTE recurrence compared to dalteparin (OR 0.48; 95% CI 0.24-0.96) but increased major bleeding (OR 1.70; 95% CI 1.04-2.78).
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