Comparing Anticoagulation Strategies for Venous Thromboembolism Associated With Active Cancer

• DOI: 10.1016/j.jaccao.2023.10.009
• Publication Date: 2024-01-09T18:57:47Z
• Authors: Tomohiro Fujisaki; Daisuke Sueta; Eiichiro Yamamoto; Conor Buckley; Guilherme Sacchi ...; Julia Aronson; Paulino Tallón de...; Koichiro Fujisue; Hiroki Usuku; Kenichi Matsushita; Roxana Mehran; George D. Dangas; Kenichi Tsujita
• Keywords: Edoxaban; Apixaban

Current guidelines recommend several direct oral anticoagulant agents (DOACs) equally for managing cancer-associated venous thromboembolism (VTE). The aim of this study was to assess the efficacy and safety DOACs in patients with active cancer. Literature searches were conducted PubMed, Embase, Cochrane Central November 2022. Randomized controlled trials investigating anticoagulation strategies (vitamin K antagonists, parenteral [eg, low-molecular weight heparin], DOACs) VTE cancer identified network meta-analysis. outcomes included recurrent VTE, pulmonary embolism, deep thrombosis, major bleeding, clinically relevant nonmajor bleeding (CRNMB), a composite outcome or CRNMB. Pooled HRs 95% CIs estimated using either HR relative risk provided from each study. Random-effects models used all analyses. Seventeen randomized involving 6,623 included. No significant differences found among (recurrent thrombosis). In terms apixaban similarly safe compared dabigatran rivaroxaban but associated decreased edoxaban (HR: 0.38; CI: 0.15-0.93). Regarding CRNMB, 0.31; 0.10-0.91). Compared anticoagulation, reduced 0.60; 0.38-0.93) without increasing an increased CRNMB 1.35; 1.02-1.79), 3.76; 1.43-9.88). demonstrate comparable exhibit different profiles. Apixaban may confer antithrombotic benefit distinguishing it other contemporary VTE.