Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE
Abstract Background The noninterventional XALIA study compared rivaroxaban with standard anticoagulation for deep vein thrombosis treatment. This substudy describes the demographics, clinical characteristics, and outcomes of the patients with cancer. Methods Therapy type, d...
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doaj-2b10d9c1b2014d6fb4dec36a525499242020-11-25T03:24:18ZengGeorg Thieme Verlag KGTH Open2512-94652017-06-010101e33e4210.1055/s-0037-1603924Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTEWalter Ageno0Lorenzo G. Mantovani1Sylvia Haas2Reinhold Kreutz3Danja Monje4Jonas Schneider5Martin van Eickels6Martin Gebel7Alexander G. G. Turpie8Department of Clinical and Experimental Medicine, University of Insubria, Varese, ItalyCESP-Center for Public Health Research, University of Milan Bicocca, Monza, ItalyTechnical University of Munich, Munich, GermanyInstitute of Clinical Pharmacology and Toxicology, Charité Universitätsmedizin, Berlin, GermanyBayer AG, Leverkusen, GermanyBayer AG, Berlin, GermanyBayer AG, Berlin, GermanyBayer AG, Wuppertal, GermanyDepartment of Medicine, Hamilton Health Sciences, Hamilton, Ontario, CanadaAbstract Background The noninterventional XALIA study compared rivaroxaban with standard anticoagulation for deep vein thrombosis treatment. This substudy describes the demographics, clinical characteristics, and outcomes of the patients with cancer. Methods Therapy type, dose, and duration were at the physician's discretion. The cohorts identified were rivaroxaban (rivaroxaban alone or after heparin or fondaparinux for ≤48 hours); early switchers (rivaroxaban after heparin or fondaparinux for >48 hours to 14 days and/or a vitamin K antagonist [VKA] for 1–14 days); standard anticoagulation (heparin or fondaparinux and a VKA); low-molecular-weight heparin (LMWH) alone; and miscellaneous (other heparins, fondaparinux alone, VKA alone). Primary outcomes were major bleeding, recurrent venous thromboembolism, and all-cause mortality. Results In XALIA, 587 patients (11.4% of the XALIA cohort) were with cancer: 146 (24.9%) rivaroxaban, 30 (5.1%) early switchers, 141 (24.0%) standard anticoagulation, 223 (38.0%) LMWH, and 47 (8.0%) miscellaneous. Patients with gastrointestinal or lung cancer more commonly received LMWH than rivaroxaban; the opposite occurred in patients with breast or genitourinary cancer. Rates of primary outcome in the rivaroxaban group were as follows: major bleeding, 1.4% (n = 2); recurrent venous thromboembolism, 3.4% (n = 5); and all-cause mortality, 4.8% (n = 7). Conclusion In XALIA, physicians treated cancer-associated thrombosis with various anticoagulant regimens, most commonly LMWH. In addition, the choice of anticoagulant varied with cancer type. In rivaroxaban-treated patients, rates for the primary outcomes were low, suggesting that patients administered rivaroxaban were a good prognosis group.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603924cancer-associated thrombosislow-molecular-weight heparinrivaroxabanroutine clinical practicevenous thromboembolism |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Walter Ageno Lorenzo G. Mantovani Sylvia Haas Reinhold Kreutz Danja Monje Jonas Schneider Martin van Eickels Martin Gebel Alexander G. G. Turpie |
spellingShingle |
Walter Ageno Lorenzo G. Mantovani Sylvia Haas Reinhold Kreutz Danja Monje Jonas Schneider Martin van Eickels Martin Gebel Alexander G. G. Turpie Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE TH Open cancer-associated thrombosis low-molecular-weight heparin rivaroxaban routine clinical practice venous thromboembolism |
author_facet |
Walter Ageno Lorenzo G. Mantovani Sylvia Haas Reinhold Kreutz Danja Monje Jonas Schneider Martin van Eickels Martin Gebel Alexander G. G. Turpie |
author_sort |
Walter Ageno |
title |
Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE |
title_short |
Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE |
title_full |
Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE |
title_fullStr |
Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE |
title_full_unstemmed |
Subgroup Analysis of Patients with Cancer in XALIA: A Noninterventional Study of Rivaroxaban versus Standard Anticoagulation for VTE |
title_sort |
subgroup analysis of patients with cancer in xalia: a noninterventional study of rivaroxaban versus standard anticoagulation for vte |
publisher |
Georg Thieme Verlag KG |
series |
TH Open |
issn |
2512-9465 |
publishDate |
2017-06-01 |
description |
Abstract
Background The noninterventional XALIA study compared rivaroxaban with standard anticoagulation for deep vein thrombosis treatment. This substudy describes the demographics, clinical characteristics, and outcomes of the patients with cancer.
Methods Therapy type, dose, and duration were at the physician's discretion. The cohorts identified were rivaroxaban (rivaroxaban alone or after heparin or fondaparinux for ≤48 hours); early switchers (rivaroxaban after heparin or fondaparinux for >48 hours to 14 days and/or a vitamin K antagonist [VKA] for 1–14 days); standard anticoagulation (heparin or fondaparinux and a VKA); low-molecular-weight heparin (LMWH) alone; and miscellaneous (other heparins, fondaparinux alone, VKA alone). Primary outcomes were major bleeding, recurrent venous thromboembolism, and all-cause mortality.
Results In XALIA, 587 patients (11.4% of the XALIA cohort) were with cancer: 146 (24.9%) rivaroxaban, 30 (5.1%) early switchers, 141 (24.0%) standard anticoagulation, 223 (38.0%) LMWH, and 47 (8.0%) miscellaneous. Patients with gastrointestinal or lung cancer more commonly received LMWH than rivaroxaban; the opposite occurred in patients with breast or genitourinary cancer. Rates of primary outcome in the rivaroxaban group were as follows: major bleeding, 1.4% (n = 2); recurrent venous thromboembolism, 3.4% (n = 5); and all-cause mortality, 4.8% (n = 7).
Conclusion In XALIA, physicians treated cancer-associated thrombosis with various anticoagulant regimens, most commonly LMWH. In addition, the choice of anticoagulant varied with cancer type. In rivaroxaban-treated patients, rates for the primary outcomes were low, suggesting that patients administered rivaroxaban were a good prognosis group. |
topic |
cancer-associated thrombosis low-molecular-weight heparin rivaroxaban routine clinical practice venous thromboembolism |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603924 |
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