Key result
Weight-adjusted enoxaparin thromboprophylaxis was feasible and well-tolerated with no major hemorrhages, while fixed-dose enoxaparin was associated with a 22% cumulative incidence of DVT.
Why the study?
Data supporting the efficacy and safety of fixed-dose LMWH thromboprophylaxis in high-risk hospitalized cancer patients were limited, with recommendations largely extrapolated from noncancer cohorts.
Does weight-adjusted enoxaparin improve safety and prevent VTE compared to fixed-dose enoxaparin in hospitalized high-risk cancer patients?
RCT (n=50)
Double-blind
randomly assigned
Yes
Does weight-adjusted enoxaparin improve safety and prevent VTE compared to fixed-dose enoxaparin in hospitalized high-risk cancer patients?
Weight-adjusted enoxaparin is feasible and well-tolerated for VTE prophylaxis in high-risk hospitalized cancer patients, who demonstrate a high incidence of asymptomatic VTE on standard fixed-dose therapy.
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Supports weight-adjusted enoxaparin for VTE prophylaxis in high-risk cancer inpatients; challenges fixed dosing given high asymptomatic DVT rates.
Zwicker et al. (2020) conducted an RCT in active cancer at high risk of developing VTE (n=50). weight-adjusted enoxaparin vs. fixed-dose enoxaparin (40 mg daily) was evaluated on safety of dose-adjusted enoxaparin and incidence of VTE with fixed-dose enoxaparin (95% CI 0%-51.3%). Weight-adjusted enoxaparin thromboprophylaxis was feasible and well-tolerated with no major hemorrhages, while fixed-dose enoxaparin was associated with a 22% cumulative incidence of DVT.
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