Key result
Direct oral anticoagulants were noninferior to LMWH for preventing recurrent VTE in patients with cancer (6.1% vs 8.8%; difference -2.7%, 1-sided 95% CI -100% to 0.7%).
Why the study?
Long-term anticoagulation with LMWH is recommended for cancer-associated VTE, but the effectiveness of DOACs compared with LMWH remained uncertain.
Does a DOAC prevent recurrent VTE as effectively as LMWH in patients with cancer and a new diagnosis of VTE?
RCT (n=671)
Unblinded
1:1
Yes
Does a DOAC prevent recurrent VTE as effectively as LMWH in patients with cancer and a new diagnosis of VTE?
Effect estimate: difference -2.7% (95% CI -100% to 0.7%)
Absolute Event Rate: 6.1% vs 8.8%
In patients with cancer and VTE, DOACs are noninferior to LMWH for preventing recurrent VTE over 6 months, supporting their use as an effective oral alternative to injectable anticoagulation.
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Supports DOAC use as oral alternative to LMWH in cancer VTE; confirms noninferiority in RCT.
Schrag et al. (2023) conducted an RCT in Cancer and venous thromboembolism (VTE) (n=671). Direct oral anticoagulant (DOAC) vs. Low-molecular-weight heparin (LMWH) was evaluated on Recurrent VTE rate at 6 months (difference -2.7%, 95% CI -100% to 0.7%). Direct oral anticoagulants were noninferior to LMWH for preventing recurrent VTE in patients with cancer (6.1% vs 8.8%; difference -2.7%, 1-sided 95% CI -100% to 0.7%).
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