Efficacy and safety of direct oral anticoagulants for preventing venous thromboembolism in hospitalized cancer patients: a national multicenter retrospective cohort study

作者：Shuyi Wu, Haiping Wang, Chunbao Li, Jingjing Tao, Xiaoli Zhu, Hengfen Dai, Hongfan Duan, Hu Tian, Miao Li, Fenfen Qu, Yun Wei, Chunhua Wang, Jinhua Zhang · 发表于：Frontiers in Pharmacology · 年份：2024 · DOI：10.3389/fphar.2024.1373635 · 被引用次数：7 · 研究领域：Venous Thromboembolism Diagnosis and Management、Heparin-Induced Thrombocytopenia and Thrombosis、Cardiac tumors and thrombi

Introduction Studies on the use of direct oral anticoagulants (DOACs) for preventing venous thromboembolism (VTE) in hospitalized cancer patients are lacking. Therefore, we conducted a multicenter retrospective cohort study to evaluate the efficacy and safety of DOACs versus low-molecular-weight heparin (LMWH) for the primary prevention of VTE in hospitalized cancer patients. Methods Clinical outcomes included thrombosis, VTE, other thrombosis, all bleeding, major bleeding, nonmajor bleeding, and all-cause death. A 1:1 cohort of rivaroxaban and LMWH patients was created by propensity score matching. Results A total of 2,385 cancer patients were included in this study. During the 3-month follow-up period, 129 (5.4%) thrombosis events occurred, 63 (2.7%) of which were VTEs and 66 (2.8%) of which were other thrombosis events. All bleeding occurred in 163 (6.8%) patients, 68 (2.9%) had major bleeding, and 95 (4.0%) had nonmajor bleeding. All-cause deaths occurred in 113 (4.7%) patients. After adjusting for various confounders, the incidence of thrombosis and other thromboses was significantly lower in the rivaroxaban group than in the LMWH group [OR 0.543, 95% CI (0.343–0.859), p = 0.009; OR 0.461, 95% CI (0.241–0.883), p = 0.020]. There were no significant differences in incidence of VTE, total bleeding, major bleeding, nonmajor bleeding, or all-cause death. Conclusion In oncology patients receiving thromboprophylaxis, rivaroxaban has a lower incidence of thrombosis and other th...