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      Long-term rivaroxaban for the treatment of acute venous thromboembolism in patients with active cancer in a prospective multicenter trial

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      https://www.riss.kr/link?id=A106335192

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      다국어 초록 (Multilingual Abstract)

      Background/Aims: Limited data are available regarding the efficacy of rivaroxaban for the treatment of cancer-associated venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban for the treatment of VTE in active cancer patients.
      Methods: In this prospective, multicenter, open-label trial (NCT01989845), we enrolled patients with active cancer and objectively diagnosed lower-extremity deep vein thrombosis, pulmonary embolism (PE), or both from November 2013 to June 2016. Active cancer was defined as a histologically confirmed malignancy, which was diagnosed or treated within the previous 6 months, or as a recurrent/ metastatic cancer. Patients received oral rivaroxaban 15 mg twice daily for first 3 weeks, followed by 20 mg once daily for 6 months. The primary outcome was the symptomatic recurrent VTE and the secondary outcomes included any recurrent VTE, major or clinically relevant non-major (CRNM) bleeding events, and overall mortality. All study outcomes were validated by blinded central adjudication.
      Results: Of 124 patients enrolled, 110 (88.7%) had solid cancer, 93 (75.0%) had metastatic disease, and 110 (88.7%) were receiving chemotherapy or radiotherapy. During the 6-month study period, seven patients experienced symptomatic recurrent VTE (cumulative incidence, 5.9%), and two patients experienced incidental recurrent PE (cumulative incidence of any recurrent VTE, 7.6%). Major bleeding events occurred in six patients (cumulative incidence, 5.3%) and CRNM bleeding events in 11 patients (cumulative incidence, 10.2%). Twenty-eight patients (overall mortality, 24.0%) died.
      Conclusions: Rivaroxaban is effective and safe for the treatment of VTE in patients with active cancer.
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      Background/Aims: Limited data are available regarding the efficacy of rivaroxaban for the treatment of cancer-associated venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban for the treatment ...

      Background/Aims: Limited data are available regarding the efficacy of rivaroxaban for the treatment of cancer-associated venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban for the treatment of VTE in active cancer patients.
      Methods: In this prospective, multicenter, open-label trial (NCT01989845), we enrolled patients with active cancer and objectively diagnosed lower-extremity deep vein thrombosis, pulmonary embolism (PE), or both from November 2013 to June 2016. Active cancer was defined as a histologically confirmed malignancy, which was diagnosed or treated within the previous 6 months, or as a recurrent/ metastatic cancer. Patients received oral rivaroxaban 15 mg twice daily for first 3 weeks, followed by 20 mg once daily for 6 months. The primary outcome was the symptomatic recurrent VTE and the secondary outcomes included any recurrent VTE, major or clinically relevant non-major (CRNM) bleeding events, and overall mortality. All study outcomes were validated by blinded central adjudication.
      Results: Of 124 patients enrolled, 110 (88.7%) had solid cancer, 93 (75.0%) had metastatic disease, and 110 (88.7%) were receiving chemotherapy or radiotherapy. During the 6-month study period, seven patients experienced symptomatic recurrent VTE (cumulative incidence, 5.9%), and two patients experienced incidental recurrent PE (cumulative incidence of any recurrent VTE, 7.6%). Major bleeding events occurred in six patients (cumulative incidence, 5.3%) and CRNM bleeding events in 11 patients (cumulative incidence, 10.2%). Twenty-eight patients (overall mortality, 24.0%) died.
      Conclusions: Rivaroxaban is effective and safe for the treatment of VTE in patients with active cancer.

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      참고문헌 (Reference)

      1 Lyman GH, "Venous thromboembolism prophylaxis and treatment in patients with cancer : American Society of Clinical Oncology clinical practice guideline update" 31 : 2189-2204, 2013

      2 Schulman S, "Treatment with dabigatran or warfarin in patients with venous thromboembolism and cancer" 114 : 150-157, 2015

      3 Francis CW, "Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months : the DALTECAN Study" 13 : 1028-1035, 2015

      4 Lee AY, "Treatment of cancer-associated thrombosis" 122 : 2310-2317, 2013

      5 Lee AYY, "Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer : a randomized clinical trial" 314 : 677-686, 2015

      6 Young A, "Thrombosis and cancer" 9 : 437-449, 2012

      7 Yhim HY, "The incidence, risk factors, and prognosis of recurrent venous thromboembolism(VTE)in patients with advanced solid cancers receiving anticoagulation therapy after the diagnosis of index VTE" 131 : e133-e140, 2013

      8 Lee KW, "The incidence, risk factors and prognostic implications of venous thromboembolism in patients with gastric cancer" 8 : 540-547, 2010

      9 Chai-Adisaksopha C, "The impact of bleeding complications in patients receiving target-specific oral anticoagulants : a systematic review and meta-analysis" 124 : 2450-2458, 2014

      10 den Exter PL, "Risk of recurrent venous thromboembolism and mortality in patients with cancer incidentally diagnosed with pulmonary embolism : a comparison with symptomatic patients" 29 : 2405-2409, 2011

      1 Lyman GH, "Venous thromboembolism prophylaxis and treatment in patients with cancer : American Society of Clinical Oncology clinical practice guideline update" 31 : 2189-2204, 2013

      2 Schulman S, "Treatment with dabigatran or warfarin in patients with venous thromboembolism and cancer" 114 : 150-157, 2015

      3 Francis CW, "Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months : the DALTECAN Study" 13 : 1028-1035, 2015

      4 Lee AY, "Treatment of cancer-associated thrombosis" 122 : 2310-2317, 2013

      5 Lee AYY, "Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer : a randomized clinical trial" 314 : 677-686, 2015

      6 Young A, "Thrombosis and cancer" 9 : 437-449, 2012

      7 Yhim HY, "The incidence, risk factors, and prognosis of recurrent venous thromboembolism(VTE)in patients with advanced solid cancers receiving anticoagulation therapy after the diagnosis of index VTE" 131 : e133-e140, 2013

      8 Lee KW, "The incidence, risk factors and prognostic implications of venous thromboembolism in patients with gastric cancer" 8 : 540-547, 2010

      9 Chai-Adisaksopha C, "The impact of bleeding complications in patients receiving target-specific oral anticoagulants : a systematic review and meta-analysis" 124 : 2450-2458, 2014

      10 den Exter PL, "Risk of recurrent venous thromboembolism and mortality in patients with cancer incidentally diagnosed with pulmonary embolism : a comparison with symptomatic patients" 29 : 2405-2409, 2011

      11 van der Hulle T, "Risk of recurrent venous thromboembolism and major hemorrhage in cancer-associated incidental pulmonary embolism among treated and untreated patients : a pooled analysis of 926 patients" 14 : 105-113, 2016

      12 Prins MH, "Oral rivaroxaban versus enoxaparin with vitamin K antagonist for the treatment of symptomatic venous thromboembolism in patients with cancer(EINSTEIN-DVT and EINSTEIN-PE) : a pooled subgroup analysis of two randomized controlled trials" 1 : e37-e46, 2014

      13 EINSTEIN-PE Investigators, "Oral rivaroxaban for the treatment of symptomatic pulmonary embolism" 366 : 1287-1297, 2012

      14 EINSTEIN Investigators, "Oral rivaroxaban for symptomatic venous thromboembolism" 363 : 2499-2510, 2010

      15 Agnelli G, "Oral apixaban for the treatment of venous thromboembolism in cancer patients : results from the AMPLIFY trial" 13 : 2187-2191, 2015

      16 Agnelli G, "Oral apixaban for the treatment of acute venous thromboembolism" 369 : 799-808, 2013

      17 van der Hulle T, "Meta-analysis of the efficacy and safety of new oral anticoagulants in patients with cancer-associated acute venous thromboembolism" 12 : 1116-1120, 2014

      18 Piran S, "Management of venous thromboembolism:an update" 14 (14): 23-, 2016

      19 Mandala M, "Management of venous thromboembolism (VTE) in cancer patients: ESMO Clinical Practice Guidelines" (22 Suppl 6) : vi85-vi92, 2011

      20 Schulman S, "Management of bleeding complications in patients with cancer on DOACs" (140 Suppl 1) : S142-S147, 2016

      21 Kearon C, "Management of anticoagulation before and after elective surgery" 336 : 1506-1511, 1997

      22 Lee AY, "Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer" 349 : 146-153, 2003

      23 Farge D, "International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer" 17 : e452-e466, 2016

      24 Jang MJ, "Incidence of venous thromboembolism in Korea : from the Health Insurance Review and Assessment Service database" 9 : 85-91, 2011

      25 Yhim HY, "Incidence of venous thromboembolism following major surgery in Korea : from the Health Insurance Review and Assessment Service database" 12 : 1035-1043, 2014

      26 Desai J, "Gastrointestinal bleeding with the new oral anticoagulants : defining the issues and the management strategies" 110 : 205-212, 2013

      27 Ay C, "Estimating risk of venous thromboembolism in patients with cancer in the presence of competing mortality" 13 : 390-397, 2015

      28 Hokusai-VTE Investigators, "Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism" 369 : 1406-1415, 2013

      29 Raskob GE, "Edoxaban for venous thromboembolism in patients with cancer : results from a non-inferiority subgroup analysis of the Hokusai-VTE randomised, double-blind, double-dummy trial" 3 : e379-e387, 2016

      30 Raskob GE, "Edoxaban for the treatment of cancer-associated venous thromboembolism" 378 : 615-624, 2018

      31 임호영, "Direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism" 대한혈액학회 49 (49): 77-79, 2014

      32 Louzada ML, "Development of a clinical prediction rule for risk stratification of recurrent venous thromboembolism in patients with cancer-associated venous thromboembolism" 126 : 448-454, 2012

      33 Schulman S, "Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients" 3 : 692-694, 2005

      34 Schulman S, "Dabigatran versus warfarin in the treatment of acute venous thromboembolism" 361 : 2342-2352, 2009

      35 Kearon C, "Antithrombotic therapy for VTE disease : CHEST guideline and expert panel report" 149 : 315-352, 2016

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      학술지 이력

      학술지 이력
      연월일 이력구분 이력상세 등재구분
      2023 평가예정 해외DB학술지평가 신청대상 (해외등재 학술지 평가)
      2020-01-01 평가 등재학술지 유지 (해외등재 학술지 평가) KCI등재
      2011-01-01 평가 등재학술지 유지 (등재유지) KCI등재
      2008-01-01 평가 등재학술지 선정 (등재후보2차) KCI등재
      2007-01-01 평가 등재후보 1차 PASS (등재후보1차) KCI등재후보
      2005-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 1.37 0.26 1.02
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.83 0.73 0.566 0.13
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