Edoxaban, Rivaroxaban, or Apixaban for Cancer-Associated Venous Thromboembolism in the Real World: Insights from the COMMAND VTE Registry-2.

IF 5 2区医学 Q1 HEMATOLOGY

Thrombosis and haemostasis Pub Date : 2024-05-24 DOI:10.1055/a-2316-5269

Daisuke Sueta, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Yuji Nishimoto, Kazuhisa Kaneda, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Takeshi Kimura, Kenichi Tsujita

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引用次数: 0

Abstract

Background: Real-world data on clinical characteristics and outcomes related to the use of different direct oral anticoagulants (DOACs) for cancer-associated venous thromboembolism (VTE) is lacking.

Methods: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive patients with acute symptomatic VTE from 31 centers in Japan from January 2015 to August 2020. Our study population comprised 1,197 patients with active cancer who were divided into the edoxaban (N = 643, 54%), rivaroxaban (N = 297, 25%), and apixaban (N = 257, 22%) groups.

Results: The cumulative 5-year incidence of recurrent VTE (9.3, 10.2, and 8.5%, respectively, p = 0.82) and all-cause death (67.5, 66.8, and 63.8%, respectively, p = 0.22) did not differ among the groups. Despite adjusting for confounders, the risks of recurrent VTE and all-cause death did not differ significantly among the groups. The cumulative 5-year incidence of major and clinically relevant bleeding was significantly lower in the rivaroxaban group than those in the other groups (22.6, 14.0, and 22.8%, p = 0.04; and 37.6, 26.8, and 38.3%, p = 0.01, respectively). After adjusting for confounders, in the rivaroxaban group, the risk for major bleeding was numerically lower (hazard ratio [HR]: 0.65, 95% confidence interval [CI]: 0.40-1.01) and that of clinically relevant all bleeding was significantly lower (HR: 0.67, 95% CI: 0.48-0.92) than those in the edoxaban group.

Conclusion: The risks of recurrent VTE and all-cause death did not differ significantly among the different DOACs ; however, the risk of bleeding events could differ, with a potentially lower risk of bleeding with rivaroxaban.

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艾多沙班、利伐沙班或阿哌沙班治疗癌症相关静脉血栓栓塞症的真实世界：COMMAND VTE 登记-2》的启示。

背景：目前还缺乏有关癌症相关静脉血栓栓塞症（VTE）使用不同直接口服抗凝药（DOACs）的临床特征和结果的真实数据：COMMAND VTE 登记-2 是一项多中心登记，从 2015 年 1 月至 2020 年 8 月，日本 31 个中心连续登记了 5197 例急性症状 VTE 患者。我们的研究对象包括1197名活动性癌症患者，他们被分为依多沙班组（N=643，54%）、利伐沙班组（N=297，25%）和阿哌沙班组（N=257，22%）：各组间复发性 VTE（分别为 9.3%、10.2% 和 8.5%，P=0.82）和全因死亡（分别为 67.5%、66.8% 和 63.8%，P=0.22）的 5 年累计发生率无差异。尽管对混杂因素进行了调整，但各组间复发性 VTE 和全因死亡的风险并无显著差异。利伐沙班组的5年累积大出血和临床相关出血发生率显著低于其他组（分别为22.6%、14.0%和22.8%，P=0.04；37.6%、26.8%和38.3%，P=0.01）。调整混杂因素后，利伐沙班组的大出血风险（HR：0.65，95% CI：0.40-1.01）和临床相关的所有出血风险（HR：0.67，95% CI：0.48-0.92）均显著低于依多沙班组：结论：不同的 DOACs 发生复发性 VTE 和全因死亡的风险没有显著差异；但出血事件的风险可能有所不同，利伐沙班的出血风险可能更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis and haemostasis 医学-外周血管病

CiteScore

11.90

自引率

9.00%

发文量

140

审稿时长

1 months

期刊介绍： Thrombosis and Haemostasis publishes reports on basic, translational and clinical research dedicated to novel results and highest quality in any area of thrombosis and haemostasis, vascular biology and medicine, inflammation and infection, platelet and leukocyte biology, from genetic, molecular & cellular studies, diagnostic, therapeutic & preventative studies to high-level translational and clinical research. The journal provides position and guideline papers, state-of-the-art papers, expert analysis and commentaries, and dedicated theme issues covering recent developments and key topics in the field.