TY - JOUR
T1 - Efficacy and safety of rivaroxaban compared to enoxaparin in treatment of cancer-associated venous thromboembolism
AU - Simmons, Benjamin
AU - Wysokinski, Waldemar
AU - Saadiq, Rayya A.
AU - Bott-Kitslaar, Dalene
AU - Henkin, Stanislav
AU - Casanegra, Ana
AU - Lenz, Charles
AU - Daniels, Paul
AU - Bjarnason, Haraldur
AU - Vargas, Emily
AU - Hodge, David
AU - Holton, Sara J.
AU - Cerhan, James R
AU - Loprinzi, Charles Lawrence
AU - McBane, Robert
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Low molecular weight heparin (LMWH) is the guideline-endorsed treatment for cancer-associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. Methods: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry, were compared to contemporary cancer patients receiving enoxaparin. The cumulative incidence of venous thromboembolism (VTE) recurrence, major and clinically relevant non-major bleeding, and survival were assessed at 3 and 12 months. Results: Ninety-eight patients received rivaroxaban (51% female, mean age 63 ± 12 years) and 168 enoxaparin (34.5% female, mean age 62 ± 15 years). The most common cancers included gastrointestinal/pancreatic, genitourinary and hematologic cancers. More than half of patients had pulmonary emboli at presentation. More than half had metastases, and two-thirds were receiving chemotherapy. At 3 months, there were no differences in VTE recurrence (rivaroxaban 1.0% vs enoxaparin 4.2%; P =.15), major bleeding (rivaroxaban 5.1% vs enoxaparin 3.6%; P =.55), or all-cause mortality (rivaroxaban 4.1% vs enoxaparin 8.9%; P =.14). At 12 months, these outcomes did not differ by treatment strategy. Conclusion: The results of this “real-world” experience with cVTE suggest that rivaroxaban may offer a safe and effective alternative to LMWH.
AB - Background: Low molecular weight heparin (LMWH) is the guideline-endorsed treatment for cancer-associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. Methods: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry, were compared to contemporary cancer patients receiving enoxaparin. The cumulative incidence of venous thromboembolism (VTE) recurrence, major and clinically relevant non-major bleeding, and survival were assessed at 3 and 12 months. Results: Ninety-eight patients received rivaroxaban (51% female, mean age 63 ± 12 years) and 168 enoxaparin (34.5% female, mean age 62 ± 15 years). The most common cancers included gastrointestinal/pancreatic, genitourinary and hematologic cancers. More than half of patients had pulmonary emboli at presentation. More than half had metastases, and two-thirds were receiving chemotherapy. At 3 months, there were no differences in VTE recurrence (rivaroxaban 1.0% vs enoxaparin 4.2%; P =.15), major bleeding (rivaroxaban 5.1% vs enoxaparin 3.6%; P =.55), or all-cause mortality (rivaroxaban 4.1% vs enoxaparin 8.9%; P =.14). At 12 months, these outcomes did not differ by treatment strategy. Conclusion: The results of this “real-world” experience with cVTE suggest that rivaroxaban may offer a safe and effective alternative to LMWH.
KW - cancer
KW - enoxaparin
KW - low molecular weight heparin
KW - rivaroxaban
KW - venous thromboembolism
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U2 - 10.1111/ejh.13074
DO - 10.1111/ejh.13074
M3 - Article
AN - SCOPUS:85050281274
SN - 0902-4441
VL - 101
SP - 136
EP - 142
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 2
ER -