Evidence map›Paper›PMID 37519604›Full record

ReviewCureus2023

Comparative Efficacy of Direct Oral Anticoagulants and Low-Molecular-Weight Heparin in Cancer-Associated Thromboembolism: A Systematic Review and Meta-Analysis.

Tirath Patel, Taha Nadeem, Usman Shahbaz, Fatima Tanveer, Muneeb Ahsan, Usman Saeed, Abdullah Ahmed, Vinesh Kumar, Syed M Ibne Ali Jaffari, Mohammad U Zaman and 4 more

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.0field-weighted citation impact, top 8% 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

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Cryptogenic embolic stroke and cancer.Frontiers in neurology · 2025
    Review
  3. Article
  4. Review
  5. Review
  6. Review
  7. Article
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

14 authors at 8 institutions in 4 countries.

Tirath PatelMedicine, American University of Antigua, Saint John, ATG.
Taha NadeemMedicine, Allama Iqbal Medical College, Lahore, PAK.
Usman ShahbazMedicine, Allama Iqbal Medical College, Lahore, PAK.
Fatima TanveerMedicine, Allama Iqbal Medical College, Lahore, PAK.
Muneeb AhsanMedicine, Allama Iqbal Medical College, Lahore, PAK.
Usman SaeedInternal Medicine, Jinnah Hospital, Lahore, PAK.
Abdullah AhmedMedicine, Allama Iqbal Medical College, Lahore, PAK.
Vinesh KumarMedicine, Chandka Medical College, Larkana, PAK.
Syed M Ibne Ali JaffariMedicine and Surgery, Shalamar Medical and Dental College, Lahore, PAK.
Mohammad U ZamanMedicine, Bacha Khan Medical College, Mardan, PAK.
Satesh KumarMedicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK.
Mahima KhatriMedicine and Surgery, Dow University of Health Sciences, Karachi, PAK.
Giustino VarrassiPain Medicine, Paolo Procacci Foundation, Rome, ITA.
Prasanthi VangaMedicine, Konaseema Institute of Medical Sciences and Research Institute, Amalapuram, IND.
Allama Iqbal Medical College · PKShalamar Hospital · PKBacha Khan University · PKFatima Jinnah Medical University · PKAmerican University of Antigua · AGDow University of Health Sciences · PKInstitute for Medical Research · MYShaheed Mohtarma Benazir Bhutto Medical University · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients diagnosed with cancer often experience an abnormal occurrence of venous thromboembolism (VTE) and its related complications. In order to evaluate the safety and effectiveness of both treatment approaches, we conducted a comprehensive systematic review and meta-analysis within the realm of cancer-associated thromboembolism. A thorough search was conducted across PubMed, the Cochrane Library, and Embase databases to find studies comparing direct oral anticoagulants (DOACs) with low molecular weight heparins (LMWHs) for the treatment of VTE in patients with malignancy. The analyses utilized the random-effects model. This meta-analysis included 11 studies. The results showed that DOACs were associated with a significantly reduced risk of VTE recurrence (RR: 0.67; 95% CI: 0.55, 0.81, p<0.0001; I2: 0%) and deep vein thrombosis (DVT) (RR: 0.63; 95% CI: 0.46, 0.86, p<0.0001; I2: 0%) compared to LMWHs. However, there was no significant difference in the risk of pulmonary embolism (PE) (RR: 0.76; 95% CI: 0.54, 1.06, p=0.11; I2: 11%) between the two groups. The use of DOACs was also associated with a non-significant increase in the risk of major bleeding events (RR: 1.23; 95% CI: 0.85, 1.78, p: 0.26; I2: 49%), while clinically relevant non-major bleeding (CRNMB) was significantly higher with DOACs (RR: 1.92; 95% CI: 1.11, 3.30, p: 0.02; I2: 81%). Secondary outcomes, such as survival rates and fatal PE, did not show significant differences between the two treatment groups. Our analysis indicates that direct oral anticoagulants exhibit a substantial decrease in the occurrence of VTE recurrence, deep vein thrombosis, and pulmonary embolism when compared to low molecular weight heparin in cancer-associated thromboembolism. However, it should be noted that DOACs carry a higher risk of CRNMB. Based on these findings, DOACs are recommended as a superior therapeutic option for managing cancer-associated thromboembolism compared to LMWH.

Indexed as

cancerdirect oral anticoagulantsdoacslmwhslow molecular weight heparinsvenous thromboembolism

Identifiers

PMID37519604
PMCPMC10375513
OpenAlexW4382399151

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.