Key result
Factor Xa inhibitors significantly reduced the risk of venous thromboembolism recurrence compared to low-molecular-weight heparin (OR 0.60) and vitamin K antagonists (OR 0.51) in cancer patients.
Why the study?
An earlier review reported no differences between factor Xa inhibitors and standard anticoagulation, prompting an updated assessment of factor Xa inhibitors for VTE management specifically in cancer patients as more RCTs became available.
Do factor Xa inhibitors reduce recurrent VTE and major bleeding in patients with cancer compared to standard anticoagulation?
Population
7,965 patients with cancer across 11 studies
Comparison
Factor Xa inhibitors vs LMWH, VKAs, or placebo
Design
Systematic review and meta-analysis of RCTs
Authors
Loading...
Factor Xa inhibitors reduce VTE recurrence versus LMWH or VKA in cancer; confirms superiority for secondary prevention and supports guideline preference.
Meta-Analysis (n=7,965)
Do factor Xa inhibitors reduce recurrent VTE and major bleeding in patients with cancer compared to standard anticoagulation?
Odds Ratio: 0.6 (95% CI 0.45–0.8)
Absolute Event Rate: 4.9% vs 9.1%
p-value: p=<0.01
Factor Xa inhibitors are more effective than LMWH and VKA in preventing VTE recurrence in cancer patients, though they may carry a higher risk of major bleeding compared to LMWH.
Nugroho et al. (2021) conducted a meta-analysis in Venous thromboembolism in cancer patients (n=7,965). Factor Xa inhibitors vs. Low-molecular-weight heparin (LMWH), Vitamin K antagonists (VKA), or placebo was evaluated on Recurrent VTE (compared to LMWH) (OR 0.60, 95% CI 0.45-0.80, p=<0.01). Factor Xa inhibitors significantly reduced the risk of venous thromboembolism recurrence compared to low-molecular-weight heparin (OR 0.60) and vitamin K antagonists (OR 0.51) in cancer patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: