Meta‐analysis of the efficacy and safety of new oral anticoagulants in patients with cancer‐associated acute venous thromboembolism

@article{Hulle2014MetaanalysisOT,
  title={Meta‐analysis of the efficacy and safety of new oral anticoagulants in patients with cancer‐associated acute venous thromboembolism},
  author={Tom van der Hulle and Paul L. den Exter and Judith Kooiman and Jorgen J. Hoeven and Menno V. Huisman and Frederikus A. Klok},
  journal={Journal of Thrombosis and Haemostasis},
  year={2014},
  volume={12},
  pages={1116 - 20}
}
Treatment of acute venous thromboembolism (VTE) in cancer patients is challenging, owing to a high risk of recurrent VTE and bleeding complications. The anticoagulants of choice are low molecular weight heparins (LMWHs), because of a proven higher efficacy than vitamin K antagonists (VKAs) and a similar bleeding profile. The recently introduced new oral anticoagulants (NOACs) have the potential to be alternative options for these patients, as these drugs share practical advantages with LMWH… Expand
Meta‐analysis of the efficacy and safety of new oral anticoagulants in patients with cancer‐associated acute venous thromboembolism: comment
TLDR
The efficacy outcome was recurrent VTE, and the safety outcome was major and clinically relevant non-major bleeding, form a solid basis for the initiation of a head-to-head comparison of NOACs with LMWH in cancer patients. Expand
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TLDR
It is concluded that although potentially interesting, future research specifically conducted in cancer patients is needed to clarify the role of these newer anticoagulant agents in prevention and treatment of cancer-related VTE. Expand
Effectiveness and safety of novel oral anticoagulants as compared with vitamin K antagonists in the treatment of acute symptomatic venous thromboembolism: a systematic review and meta‐analysis
TLDR
A meta‐analysis was performed to determine the efficacy and safety of NOACs as compared with those of VKAs in patients with acute VTE. Expand
Direct oral anticoagulants for the treatment of acute venous thromboembolism in patients with cancer: a meta-analysis of randomised controlled trials
TLDR
DOACs have a marginally higher antithrombotic efficacy and a comparable safety than VKA in cancer patients with VTE. Expand
Direct oral anticoagulants for the treatment of cancer-associated venous thromboembolism.
TLDR
Subgroup analyses of patients treated with direct oral anticoagulants suggest that DOACs could be a safe and efficacious alternative to VKA therapy for the treatment of cancer-associated VTE, but the populations of cancer patients included in the DOAC and LMWH trials are not comparable with regard to mortality and VTE risk, and no specific data from direct head-to-head comparisons ofDOACs with LMWHs are currently available. Expand
Novel or non-vitamin K antagonist oral anticoagulants and the treatment of cancer-associated thrombosis.
TLDR
The use of these newer oral anticoagulants in cancer patients is not recommended, as their safety and efficacy are not yet established and the complexity of these patients warrants further cancer-specific clinical trials. Expand
An update on the efficacy and safety of novel anticoagulants for cancer associated thrombosis
  • B. Cosmi
  • Medicine
  • Expert opinion on pharmacotherapy
  • 2020
TLDR
This review examines the role of low molecular weight heparins (LMWH), which have been the standard of care for CAT treatment for many years and discusses the results of two RCTs which separately compared the direct oral factor Xa inhibitors, apixaban or rivaroxaban, with placebo for CAT prophylaxis in ambulatory high-risk cancer patients and found that DOACS reduced VTE but increased bleeding. Expand
Direct oral anticoagulants and venous thromboembolism
TLDR
This narrative review focusses on the characteristics of these direct anticoagulants and the main results of published clinical studies on their use in the prevention and treatment of VTE. Expand
Role of Novel Oral Anticoagulants in Primary and Secondary Thromboprophylaxis in Cancer
TLDR
Although the routine use of novel oral anticoagulants for the prevention or treatment of venous thromboembolism in cancer patients cannot be recommended at this time, the development of Phase III trials assessing their efficacy and safety in patients with active malignancies compared to the current standard of care treatment with low molecular weight heparin is strongly supported. Expand
Direct oral anticoagulants for the treatment of venous thromboembolism in patients with active malignancy: a systematic review and meta-analysis
TLDR
The results suggest that DOACs might reduce the incidence of VTE recurrence in patients with cancer without putting them at high risk for MB/CRNMB or MB. Expand
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