Effectiveness and safety of continuous low-molecular-weight heparin versus switching to direct oral anticoagulants in cancer-associated venous thrombosis.
Wei KangCaige HuangVincent Ka Chun YanYue WeiJessica J P ShamiSilvia T H LiYu YangXuxiao YeJunhan TangShing-Fung LeeVictor Ho Fun LeeStephen Lam ChanAya El HelaliKa-On LamRoger K C NganIan Chi Kei Ck WongEsther Wai Yin ChanPublished in: Nature communications (2024)
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.
Keyphrases
- direct oral anticoagulants
- venous thromboembolism
- atrial fibrillation
- healthcare
- public health
- newly diagnosed
- end stage renal disease
- prognostic factors
- mental health
- risk assessment
- combination therapy
- growth factor
- emergency department
- social media
- health information
- replacement therapy
- electronic health record
- patient reported