Evidence map›Paper›PMID 37421494›Full record

ArticleJournal of thrombosis and thrombolysis2023

Evaluation of direct oral anticoagulants versus low molecular weight heparins for venous thromboembolism treatment in patients with gastrointestinal malignancies.

Tiffany Guan, Arianna Laguna, Alisha Soares, Carlo S Legasto, Shanna Block, Ila M Saunders, Kathryn Alvarez, Tiffany Pon, Nimish Patel, Anjlee Mahajan and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
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

11 authors at 3 institutions in 1 country.

Tiffany GuanDepartment of Pharmaceutical Services, University of California, San Francisco Medical Center, San Francisco, CA, USA. Tiffany.Guan@ucsf.edu.ORCID http://orcid.org/0000-0003-4332-0891
Arianna LagunaDepartment of Pharmacy Services, University of California, Davis Medical Center, Sacramento, CA, USA.
Alisha SoaresDepartment of Pharmacy, University of California, San Diego Health, La Jolla, CA, USA.
Carlo S LegastoDepartment of Pharmaceutical Services, University of California, San Francisco Medical Center, San Francisco, CA, USA.
Shanna BlockDepartment of Pharmacy, University of California, San Diego Health, La Jolla, CA, USA.
Ila M SaundersSkaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Kathryn AlvarezDepartment of Pharmacy Services, University of California, Davis Medical Center, Sacramento, CA, USA.
Tiffany PonDepartment of Pharmacy Services, University of California, Davis Medical Center, Sacramento, CA, USA.
Nimish PatelSkaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Anjlee MahajanDepartment of Hematology/Oncology, University of California, Davis Medical Center, Sacramento, CA, USA.
Angela LeeDepartment of Pharmaceutical Services, University of California, San Francisco Medical Center, San Francisco, CA, USA.
University of California Davis Medical Center · USUniversity of California San Diego · USUniversity of California San Francisco Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDirect oral anticoagulant (DOAC) use in cancer-associated venous thromboembolism (CA-VTE) has increased due to updates in recent guidelines and literature. However, select guidelines caution against DOAC use in patients with gastrointestinal (GI) malignancies due to reported increased bleeding events. The objective of this study was to compare the safety and effectiveness of DOACs versus low-molecular-weight heparins (LMWHs) for CA-VTE treatment in patients with GI malignancies. PATIENTS AND

methodsThis multicenter, retrospective cohort study included patients with primary GI malignancies who received therapeutic anticoagulation with a DOAC or LMWH for CA-VTE between January 1, 2018, and December 31, 2019. The primary outcome was the incidence rate of bleeding events (major, clinically relevant non-major, or minor bleeding events) within a 12-month period following the initiation of therapeutic anticoagulation. The secondary endpoint was the incidence rate of recurrent VTE events within a 12-month period following the start of therapeutic anticoagulation.

resultsAfter screening, 141 patients met inclusion criteria. The incidence rate of all bleeding events significantly differed between DOAC (4.98 events/100 person-months) and LWMH (10.2 events/100 person-months) recipients. The corresponding incidence rate ratio (IRR) with the DOAC group serving as the reference was 2.05 (p = 0.01), with the majority of bleeds in both groups presenting as minor bleeds. No difference was found between the incidence rate of recurrent VTE within a 12-month period of starting therapeutic anticoagulation between groups (IRR 3.08, p = 0.06).

conclusionOur results suggest that DOACs do not pose an additional bleeding risk compared to LMWH in patients with certain GI malignancies. Careful selection of DOAC therapy with respect to bleeding risk is still warranted.

Indexed as

Gastrointestinal NeoplasmsNeoplasmsVenous ThromboembolismAdministration, OralAnticoagulantsHemorrhageHeparin, Low-Molecular-WeightHumansRetrospective StudiesAnticoagulantsHeparin, Low-Molecular-WeightDirect oral anticoagulantDOACGastrointestinal malignanciesLMWHLow-molecular-weight heparinVenous thromboembolismVTE

Identifiers

PMID37421494
OpenAlexW4383620280

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.