1. Effectiveness and safety of continuous low-molecular-weight heparin versus switching to direct oral anticoagulants in cancer-associated venous thrombosis.
- Author
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Kang W, Huang C, Yan VKC, Wei Y, Shami JJP, Li STH, Yang Y, Ye X, Tang J, Lee SF, Lee VHF, Chan SL, El Helali A, Lam KO, Ngan RKC, Wong ICK, and Chan EW
- Subjects
- Humans, Female, Male, Middle Aged, Aged, Administration, Oral, Hong Kong epidemiology, Treatment Outcome, Venous Thromboembolism drug therapy, Venous Thromboembolism etiology, Cohort Studies, Hospitalization statistics & numerical data, Drug Substitution, Aged, 80 and over, Neoplasms drug therapy, Neoplasms complications, Heparin, Low-Molecular-Weight administration & dosage, Heparin, Low-Molecular-Weight adverse effects, Heparin, Low-Molecular-Weight therapeutic use, Anticoagulants administration & dosage, Anticoagulants therapeutic use, Anticoagulants adverse effects, Venous Thrombosis drug therapy, Hemorrhage chemically induced
- Abstract
Given the existing uncertainty regarding the effectiveness and safety of switching from low-molecular-weight heparin (LMWH) to direct oral anticoagulants (DOACs) in patients with cancer-associated venous thrombosis (CAT), we conducted a comprehensive population-based cohort study utilizing electronic health database in Hong Kong. A total of 4356 patients with CAT between 2010 and 2022 were included, with 1700 (39.0%) patients switching to DOAC treatment. Compared to continuous LMWH treatment, switching to DOACs was associated with a significantly lower risk of hospitalization due to venous thromboembolism (HR: 0.49 [95% CI = 0.35-0.68]) and all-cause mortality (HR: 0.67 [95% CI = 0.61-0.74]), with no significant difference in major bleeding (HR: 1.04 [95% CI = 0.83-1.31]) within six months. These findings provide reassurance regarding the effectiveness and safety of switching from LMWH to DOACs among patients with CAT, including vulnerable patient groups., (© 2024. The Author(s).)
- Published
- 2024
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