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September 16, 2021Thrombosis and HaemostasisOpen Access

Apixaban and Dalteparin for the Treatment of Venous Thromboembolism in Patients with Different Sites of Cancer

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Why the study?

The efficacy and safety of anticoagulant treatment for venous thromboembolism may vary depending on the primary cancer site.

Does oral apixaban compared to subcutaneous dalteparin improve efficacy and safety in patients with cancer-associated VTE across different cancer sites?

Population

Patients with VTE and different cancer sites randomized in the Caravaggio study

Comparison

Oral apixaban vs subcutaneous dalteparin

Design

Subgroup analysis of a randomized trial

Follow-up

6 months

Authors

GAGiancarlo AgnelliAMAndrés J. Muñoz MartínLFLaura Franco

Discussion

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Member takes

Overview

Apixaban offers consistent efficacy and safety across cancer sites; subgroup findings leave open questions on site-specific risk differences.

Structured PICO

Does oral apixaban compared to subcutaneous dalteparin improve efficacy and safety in patients with cancer-associated VTE across different cancer sites?

P
Population
Patients with cancer-associated venous thromboembolism (VTE) with different primary cancer sites (gastrointestinal, lung, breast, genitourinary, gynecological, hematological) randomized in the Caravaggio study
I
Intervention
Oral apixaban for 6 months
C
Comparator
Subcutaneous dalteparin for 6 months
O
Outcome
Rates of VTE recurrence and major bleedinghard clinical

Oral apixaban is a valid alternative to subcutaneous dalteparin for treating cancer-associated VTE across a wide spectrum of primary cancer sites, with no significant differences in efficacy or safety by site.

Cite This Study

Agnelli et al. (2021) studied this question.

synapsesocial.com/papers/6a91b75bf436dc98e0a5bc74https://doi.org/10.1055/s-0041-1735194
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Also Consider

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

  1. 1Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism2017 · 1,633 citations
  2. 2A snapshot of cancer-associated thromboembolic disease in 2018–2019: First data from the TESEO prospective registry2020 · 39 citations
  3. 3A Proportional Hazards Model for the Subdistribution of a Competing Risk1999 · 13,927 citations
  4. 4Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D)2018 · 1,347 citations
  5. 52019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)2019 · 4,990 citations