Treatment of venous thromboembolism in patients with cancer: subgroup analysis of the Matisse clinical trials. - Université Jean-Monnet-Saint-Étienne Accéder directement au contenu
Article Dans Une Revue Thrombosis and Haemostasis Année : 2009

Treatment of venous thromboembolism in patients with cancer: subgroup analysis of the Matisse clinical trials.

Résumé

In the initial treatment of venous thromboembolism (VTE) fondaparinux, a pentasaccharide, is a good alternative to heparin. Whether this is also true for cancer patients is unknown. We performed two post-hoc analyses of two randomized studies to compare efficacy, safety and overall survival of fondaparinux to standard initial (low-molecular-weight) heparin (LMWH) treatment in cancer patients with venous thromboembolism. Two hundred thirty-seven cancer patients with deep venous thrombosis (DVT) were initially treated with fondaparinux or enoxaparin. Two hundred forty cancer patients with pulmonary embolism (PE) received fondaparinux or unfractionated heparin. The initial treatment was followed by vitamin K antagonists. In DVT patients, the three-month recurrence rate was 5.4% in the enoxaparin recipients compared to 12.7% in those treated with fondaparinux [absolute difference 7.3%, 95% CI 0.1, 14.5]. A recurrence was observed in 8.9% of the PE patients treated with fondaparinux compared to 17.2% in the unfractionated heparin recipients [absolute difference -8.3, 95% CI -16.7, 0.1]. In both studies no difference in bleeding and overall survival was observed. Regarding overall survival and bleeding fondaparinux is comparable to enoxaparin and unfractionated heparin in cancer patients. No significant differences in recurrent VTE were observed when comparing fondaparinux with unfractionated or LMWH. Because of study limitations these results should be considered hypothesis-generating.

Domaines

Pharmacologie
Fichier non déposé

Dates et versions

ujm-00440041 , version 1 (09-12-2009)

Identifiants

  • HAL Id : ujm-00440041 , version 1
  • PUBMED : 19350123

Citer

Frederiek F van Doormaal, Gary E Raskob, Bruce L Davidson, Hervé Decousus, Alexander Gallus, et al.. Treatment of venous thromboembolism in patients with cancer: subgroup analysis of the Matisse clinical trials.. Thrombosis and Haemostasis, 2009, 101 (4), pp.762-9. ⟨ujm-00440041⟩
31 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More