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September 30, 2016Journal of Thrombosis and ThrombolysisOpen Access

Safe and effective use of rivaroxaban for treatment of cancer-associated venous thromboembolic disease: a prospective cohort study

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Key result

In patients with active cancer and venous thromboembolism, rivaroxaban treatment resulted in a 6-month cumulative incidence of recurrent VTE of 4.4% and major bleeding of 2.2%.

Why the study?

Does rivaroxaban prevent recurrent VTE without excessive bleeding in patients with cancer-associated thrombosis?

Population

200 patients with active cancer and cancer-associated thrombosis, mean age 63 years, 40% male. 183 had solid…

Design

Cohort

Follow-up

6 months

Authors

SMSimon ManthaELEva LaubeYMYimei Miao

Discussion

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Overview

May support rivaroxaban evaluation in CAT; leaves open randomized confirmation versus LMWH.

Study Design

Type

Cohort (n=200)

Multicenter

No

Structured PICO

Does rivaroxaban prevent recurrent VTE without excessive bleeding in patients with cancer-associated thrombosis?

P
Population
200 patients with active cancer and acute cancer-associated pulmonary embolism or symptomatic proximal deep vein thrombosis treated with rivaroxaban and followed for 6 months.
E
Exposure
Rivaroxaban 15 mg orally twice daily for 3 weeks followed by 20 mg daily (reduced to 10 mg twice daily for 3 weeks then 15 mg daily for age ≥75 years) for 6 months.
O
Outcome
Competing risk analysis at 6 months including new or recurrent PE or symptomatic proximal lower extremity DVT, major bleeding, clinically-relevant non-major bleeding leading to discontinuation of rivaroxaban, or death.composite

Rivaroxaban appears safe and effective for the treatment of cancer-associated thrombosis, with rates of recurrent VTE and major bleeding comparable to historical data for low-molecular-weight heparin.

Limitations

  • Small sample size
  • Non-randomized observational design allowing for potential selection bias
  • Non-randomized nature
  • Potential selection bias

Cite This Study

Mantha et al. (2016) conducted a cohort in Cancer-associated venous thromboembolic disease (n=200). Rivaroxaban was evaluated on New or recurrent VTE at 6 months (95% CI 1.4-7.4). In patients with active cancer and venous thromboembolism, rivaroxaban treatment resulted in a 6-month cumulative incidence of recurrent VTE of 4.4% and major bleeding of 2.2%.

synapsesocial.com/papers/6a6bfbeb01245da06ecbaa2chttps://doi.org/10.1007/s11239-016-1429-1
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Also Consider

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

  1. 1Low-Molecular-Weight Heparin versus a Coumarin for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer2003 · 2,542 citations
  2. 2Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism: a pooled analysis of the EINSTEIN-DVT and PE randomized studies2013 · 555 citations
  3. 3Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism2013 · 1,883 citations
  4. 4Oral Apixaban for the Treatment of Acute Venous Thromboembolism2013 · 2,335 citations
  5. 5Oral Rivaroxaban for Symptomatic Venous Thromboembolism2010 · 3,276 citations