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October 10, 2023Thrombosis and Haemostasis

Risk Factors for Bleeding in Cancer Patients Treated with Conventional Dose Followed by Low-Dose Apixaban for Venous Thromboembolism

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Why the study?

The incidence of and risk factors for bleeding in cancer patients with VTE treated with apixaban are poorly described.

What are the risk factors for clinically relevant bleeding in cancer patients treated with apixaban for venous thromboembolism?

Population

298 cancer patients with any type of VTE

Comparison

5 mg apixaban twice daily for 6 months, then 2.5 mg twice daily for 30 months

Design

Prospective study

Follow-up

36 months

Authors

PHParwana HussainiTLTrine‐Lise LarsenWGWaleed Ghanima

Discussion

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Member takes

Overview

May flag higher early bleeding risk on apixaban in cancer VTE; leaves open need for prospective validation before guiding therapy.

Structured PICO

What are the risk factors for clinically relevant bleeding in cancer patients treated with apixaban for venous thromboembolism?

P
Population
298 cancer patients with any type of venous thromboembolism (VTE)
I
Intervention
Apixaban 5 mg twice daily for 6 months, followed by 2.5 mg twice daily for 30 months
O
Outcome
Clinically relevant bleedings (composite of major bleedings and clinically relevant nonmajor bleedings)safety

In cancer patients with VTE treated with apixaban, bleeding risk is highest during the first 6 months of full-dose therapy and is associated with advanced age, low BMI, low hemoglobin, and nonresected luminal GI cancer.

Cite This Study

Hussaini et al. (2023) studied this question.

synapsesocial.com/papers/6a1bf8a4d54006be995f53dahttps://doi.org/10.1055/a-2188-8773
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry2008 · 518 citations
  2. 2Bleeding Complications in Oral Anticoagulant Therapy1993 · 435 citations
  3. 3The Risk for and Severity of Bleeding Complications in Elderly Patients Treated with Warfarin1996 · 558 citations
  4. 4Risk factors for recurrence and major bleeding in patients with cancer-associated venous thromboembolism2023 · 46 citations
  5. 5Advanced Age, Anticoagulation Intensity, and Risk for Intracranial Hemorrhage among Patients Taking Warfarin for Atrial Fibrillation2004 · 532 citations