Key result
Fondaparinux was more effective than low molecular weight heparins regarding total clinical benefit in cancer patients, and a reduced dose of 1.5 mg/day is safe in patients over 85 years old.
Why the study?
Patients with malignancies face high risks of thrombotic events that complicate treatment and worsen survival, with parenteral anticoagulants forming the basis of prevention.
Does fondaparinux sodium improve total clinical benefit and reduce bleeding risk compared to LMWH in cancer patients?
Does fondaparinux sodium improve total clinical benefit and reduce bleeding risk compared to LMWH in cancer patients?
Fondaparinux sodium is an effective and safe alternative to LMWH for the prevention and treatment of VTE in cancer patients, offering advantages in specific high-risk subgroups.
May support fondaparinux in cancer VTE; leaves open randomized confirmation of benefit and elderly dosing.
Patients with malignancies are at high risk of thrombotic events complicating treatment and worsening survival. Currently, parenteral anticoagulants underlie specific prevention of cancer-related thromboembolic complications. Parenteral fondaparinux sodium deserves a special attention as a synthetic selective inhibitor of factor Xa. Randomized studies revealed similar effectiveness of fondaparinux sodium with minimal risk of major bleedings in VTE complications compared to LMWH in surgery cancer patients. «Start the next morning» mode of anticoagulation with fondaparinux in cancer patients reduces the risk of massive bleeding without reducing effectiveness. A meta-analysis of 12 randomized controlled trials demonstrated that fondaparinux was more effective than low molecular weight heparins regarding total clinical benefit. This anticoagulant is also effective and safe for the treatment of VTE. In addition, fondaparinux is safer in patients with low platelet count. Reduced dose (1.5 mg/day) is safe in patients over 85 years old, with renal failure and creatinine clearance 20—50 ml/min.
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Сомонова et al. (2024) conducted a review in Cancer-related thromboembolic complications. Fondaparinux sodium vs. Low molecular weight heparins (LMWH) was evaluated. Fondaparinux was more effective than low molecular weight heparins regarding total clinical benefit in cancer patients, and a reduced dose of 1.5 mg/day is safe in patients over 85 years old.
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