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Rivaroxaban Versus Low-molecular-weight Heparin for Venous Thromboembolism in Advanced Upper Gastrointestinal Tract and Hepatopancreatobiliary Cancer.


ABSTRACT: BACKGROUND/AIM:The aim of this study was to examine the efficacy and safety of direct oral anticoagulants for cancer-associated venous thromboembolism (VTE) in patients with active cancer. PATIENTS AND METHODS:This study included patients with advanced unresectable/metastatic upper gastrointestinal (GI) or hepatopancreatobiliary (HPB) cancers with high risks of VTE and bleeding. RESULTS:No significant differences were noted in potential bleeding factors between the rivaroxaban (n=105) and low-molecular-weight heparin (LMWH) (n=69) groups. Rivaroxaban exhibited similar risk of recurrent/aggravated VTE compared with LMWH (p=0.625) but increased risk of major bleeding (17.4% vs. 7.6%; p=0.072), clinically relevant bleeding (31.9% vs. 14.3%; p=0.019), and total bleeding (40.6% vs. 19%; p=0.010). The multivariate analysis regarded rivaroxaban as a significant factor for major bleeding (p=0.043) and clinically relevant bleeding (p=0.043). CONCLUSION:Rivaroxaban exhibits comparable efficacy but increases bleeding risks compared with LMWH in patients with active unresectable/metastatic upper GI tract or HPB cancers, requiring extra caution of higher major bleeding risks.

SUBMITTER: Kim JH 

PROVIDER: S-EPMC7157862 | biostudies-literature | 2020 Mar-Apr

REPOSITORIES: biostudies-literature

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Rivaroxaban <i>Versus</i> Low-molecular-weight Heparin for Venous Thromboembolism in Advanced Upper Gastrointestinal Tract and Hepatopancreatobiliary Cancer.

Kim Jwa Hoon JH   Seo Seyoung S   Kim Kyu-Pyo KP   Chang Heung-Moon HM   Ryoo Baek-Yeol BY   Yoo Changhoon C   Jeong Jae Ho JH   Lee Jae-Lyun JL   Im Hyeon-Su HS   Jeong Hyehyun H   Bang Yeonghak Y   Park Sook Ryun SR  

In vivo (Athens, Greece) 20200301 2


<h4>Background/aim</h4>The aim of this study was to examine the efficacy and safety of direct oral anticoagulants for cancer-associated venous thromboembolism (VTE) in patients with active cancer.<h4>Patients and methods</h4>This study included patients with advanced unresectable/metastatic upper gastrointestinal (GI) or hepatopancreatobiliary (HPB) cancers with high risks of VTE and bleeding.<h4>Results</h4>No significant differences were noted in potential bleeding factors between the rivaroxa  ...[more]

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