Evidence map›Paper›PMID 36577902›Full record

ArticleJournal of cancer research and clinical oncology2023

DOAC in the treatment of cancer-associated venous thromboembolism: a retrospective cohort study beyond the guidelines.

Mattia Cominacini, Silvia Suardi, Giulia Ferrari, Roberto Ciresa, Federica Tosi, Sergio De Marchi, Maria Teresa Valenti, Luca Dalle Carbonare

Open access · hybridAbstract read
In one paragraph

Article in Journal of cancer research and clinical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Mattia CominaciniDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy.
Silvia SuardiDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy.
Giulia FerrariDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy.
Roberto CiresaDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy.
Federica TosiDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy.
Sergio De MarchiDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy.
Maria Teresa ValentiDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134, Verona, Italy.
Luca Dalle CarbonareDepartment of Medicine, Section of Internal Medicine, University of Verona, Piazzale Scuro, 10, Policlinico G.B. Rossi, 37134, Verona, Italy. luca.dallecarbonare@univr.it.
University of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe emerging use of direct oral anticoagulants (DOAC) in the management of cancer-associated venous thromboembolism (CAT) is significantly improving therapeutic adherence and quality of life. Despite this, many conditions can restrict the therapeutic index of these drugs. For all these reasons the latest guidelines recommend the use of heparins in the treatment of CAT as the preferred treatment in some clinical settings.

objectivesWe evaluated the efficacy and the safety of DOAC, in terms of recurrent venous thromboembolism (VTE) and major bleeding (MB), as a composite primary outcome. Mortality and clinically relevant non-major bleeding (CRNMB) were evaluated as secondary outcomes.

methodsWe performed a retrospective study on 209 patients to compare the effects of DOAC versus heparins for the treatment of CAT. 127 patients with a high bleeding risk neoplasia were enrolled.

resultsA primary-outcome event occurred in 11.3% of patients treated with heparins and in 10.5% treated with DOAC (Relative Risk 0.92; 95% CI 0.42-2.01, p = 0.84). Recurrent VTE occurred in 6.1% in the heparins group and in 8.4% in the DOAC group (RR 1.37; 95% CI 0.51-3.64, p = 0.52). MB occurred in 5.2% in the heparins group and in 2.1% in the DOAC group (RR 0.40; 95% CI 0.08-1.93, p = 0.25).

conclusionsDOAC seem to be as effective and safe as heparins in the treatment of CAT. Most bleeding events occurred in patients with high-risk bleeding neoplasms regardless of the type of anticoagulant. Considering the characteristics and satisfaction of patients using DOAC in this setting, this approach should be considered as a first choice.

Indexed as

NeoplasmsVenous ThromboembolismAdministration, OralAnticoagulantsHemorrhageHeparinHumansQuality of LifeRetrospective StudiesAnticoagulantsHeparinAnticoagulantsCancerDOACSafetyThromboembolism

Identifiers

PMID36577902
PMCPMC10356843
OpenAlexW4313197723

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.