Efficacy and safety of novel oral anticoagulants versus low molecular weight heparin in cancer patients with venous thromboembolism: A systematic review and meta-analysis

Filippo Crea, Massimiliano Camilli, Marco Lombardi, Marco Giuseppe Del Buono, Mattia Galli, Nadia Aspromonte, Giampaolo Niccoli, Rocco Antonio Montone, Giovanni Maria Vescovo, Giuseppe Biondi Zoccai, Giorgio Minotti

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Novel Oral Anticoagulants (NOACs) have been considered for treating cancer-related venous thromboembolism (VTE), but safety issues have been raised. We performed a systematic review and pairwise meta-analysis of the efficacy and safety of NOACs versus low molecular weight heparin (LMWH) in this setting. Four randomized controlled trials were included, providing data on 2894 patients. Compared to LMWH, NOACs were associated with a significantly lower risk of VTE recurrence and were not associated with an increased risk of major bleedings (MB). NOACs were non inferior to LMWH for a composite outcome of VTE recurrence and MB, pulmonary embolism recurrence and all-cause mortality; however, NOACs were associated with an increased risk of clinically relevant nonmajor bleedings (CRNMB) and gastrointestinal MB. In conclusion, in patients with cancer-related VTE, NOACs are effective and safe in reducing VTE recurrence compared to LMWH. An increased risk of CNRMB and GI MB should nonetheless be considered.
Original languageEnglish
Pages (from-to)103074-N/A
JournalCRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
DOIs
Publication statusPublished - 2020

Keywords

  • Bleedings
  • Cancer-related venous thromboembolism
  • Low molecular weight heparin
  • Novel oral anticoagulants
  • Personalized medicine
  • Venous Thromboembolism
  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Humans
  • Neoplasms
  • Administration, Oral

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