Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre
Abstract Background Venous Thromboembolism (VTE) in cancer patients is associated with increased mortality and morbidity. While newer data on use of direct oral anticoagulants (DOACs) in treating cancer associated thrombosis (CAT) is promising; its data is still few and inconsistent across literatur...
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doaj-64ddbf76998d4bac82e487ae581c61ad2020-11-25T03:17:19ZengBMCThrombosis Journal1477-95602020-05-011811610.1186/s12959-020-00221-2Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centreAnadil Faqah0Hassan Sheikh1Muhammad Abu Bakar2Fatima Tayyaab3Sahrish Khawaja4Department of Internal Medicine, Shaukat Khanam Memorial Cancer Hospital & Research CentreDepartment of Hematology and Oncology, Shaukat Khanam Memorial Cancer Hospital & Research CentreDepartment of Cancer Registry, Shaukat Khanam Memorial Cancer Hospital & Research CentreDepartment of Internal Medicine, Shaukat Khanam Memorial Cancer Hospital & Research CentreDepartment of Internal Medicine, Shaukat Khanam Memorial Cancer Hospital & Research CentreAbstract Background Venous Thromboembolism (VTE) in cancer patients is associated with increased mortality and morbidity. While newer data on use of direct oral anticoagulants (DOACs) in treating cancer associated thrombosis (CAT) is promising; its data is still few and inconsistent across literature. We designed the study to assess if rivaroxaban would be an appealing alternate choice to treat CAT. Methods We conducted a retrospective study to evaluate the efficacy and safety profile of rivaroxaban versus enoxaparin in cancer patients after developing a symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE). Baseline patient characteristics and laboratory values were assessed in each arm. Primary efficacy outcome was measured by radiographically confirmed VTE recurrence at different intervals. Primary safety outcome was measured by presence of major and minor bleeding using the ISTH scale. Results Our study recruited 150 cancer patients with radiologically confirmed DVT and PE; 80 patients were evaluated in enoxaparin arm and 70 patients in rivaroxaban arm. Our results showed that there was no statistically significant difference between the incidence of VTE recurrence at 6 months between the enoxaparin and rivaroxaban arm (10% vs 14.2%, p = 0.42). Historically significant risk factors for VTE in cancer patients such as high platelet count, high leukocyte count, low hemoglobin level, high risk gastrointestinal, genitourinary and lung cancers were not found to be significantly associated with the risk of VTE recurrence. Primary safety outcome analysis also showed no statistically significant difference in major (11.2% vs 11.4%) and minor (15% vs 10%) bleeding between enoxaparin versus rivaroxaban arm respectively (p = 0.65). Conclusion We conclude that there was no significant difference seen between the efficacy and safety profile of enoxaparin and rivaroxaban in our cancer patient population.http://link.springer.com/article/10.1186/s12959-020-00221-2AnticoagulantsRivaroxabanFactor Xa inhibitorThrombosisLow-molecular-weight-heparinCancer-associated-thrombosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anadil Faqah Hassan Sheikh Muhammad Abu Bakar Fatima Tayyaab Sahrish Khawaja |
spellingShingle |
Anadil Faqah Hassan Sheikh Muhammad Abu Bakar Fatima Tayyaab Sahrish Khawaja Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre Thrombosis Journal Anticoagulants Rivaroxaban Factor Xa inhibitor Thrombosis Low-molecular-weight-heparin Cancer-associated-thrombosis |
author_facet |
Anadil Faqah Hassan Sheikh Muhammad Abu Bakar Fatima Tayyaab Sahrish Khawaja |
author_sort |
Anadil Faqah |
title |
Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre |
title_short |
Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre |
title_full |
Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre |
title_fullStr |
Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre |
title_full_unstemmed |
Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre |
title_sort |
comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre |
publisher |
BMC |
series |
Thrombosis Journal |
issn |
1477-9560 |
publishDate |
2020-05-01 |
description |
Abstract Background Venous Thromboembolism (VTE) in cancer patients is associated with increased mortality and morbidity. While newer data on use of direct oral anticoagulants (DOACs) in treating cancer associated thrombosis (CAT) is promising; its data is still few and inconsistent across literature. We designed the study to assess if rivaroxaban would be an appealing alternate choice to treat CAT. Methods We conducted a retrospective study to evaluate the efficacy and safety profile of rivaroxaban versus enoxaparin in cancer patients after developing a symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE). Baseline patient characteristics and laboratory values were assessed in each arm. Primary efficacy outcome was measured by radiographically confirmed VTE recurrence at different intervals. Primary safety outcome was measured by presence of major and minor bleeding using the ISTH scale. Results Our study recruited 150 cancer patients with radiologically confirmed DVT and PE; 80 patients were evaluated in enoxaparin arm and 70 patients in rivaroxaban arm. Our results showed that there was no statistically significant difference between the incidence of VTE recurrence at 6 months between the enoxaparin and rivaroxaban arm (10% vs 14.2%, p = 0.42). Historically significant risk factors for VTE in cancer patients such as high platelet count, high leukocyte count, low hemoglobin level, high risk gastrointestinal, genitourinary and lung cancers were not found to be significantly associated with the risk of VTE recurrence. Primary safety outcome analysis also showed no statistically significant difference in major (11.2% vs 11.4%) and minor (15% vs 10%) bleeding between enoxaparin versus rivaroxaban arm respectively (p = 0.65). Conclusion We conclude that there was no significant difference seen between the efficacy and safety profile of enoxaparin and rivaroxaban in our cancer patient population. |
topic |
Anticoagulants Rivaroxaban Factor Xa inhibitor Thrombosis Low-molecular-weight-heparin Cancer-associated-thrombosis |
url |
http://link.springer.com/article/10.1186/s12959-020-00221-2 |
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