Evidence map›Paper›PMID 38301711›Full record

Observational studyThrombosis and haemostasis2025

Comparison of Clinical Outcomes in Patients with Active Cancer Receiving Rivaroxaban or Low-Molecular-Weight Heparin: The OSCAR-UK Study.

Alexander T Cohen, Christopher Wallenhorst, Marcella Rivera, Cihan Ay, Bernhard Schaefer, Khaled Abdelgawwad, George Psaroudakis, Gunnar Brobert, Anders Ekbom, Agnes Y Y Lee and 5 more

Open access · hybridAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Thrombosis and haemostasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 6% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Rivaroxaban versus Low Molecular Weight Heparin for Cancer-Associated Venous Thromboembolism: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  3. Review
  4. Review
  5. 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

15 authors at 10 institutions in 7 countries.

Alexander T CohenDepartment of Haematological Medicine, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom.
Christopher WallenhorstInstitute for Epidemiology, Statistics and Informatics GmbH, Frankfurt am Main, Germany.ORCID 0000-0001-7944-7347
Marcella RiveraBayer AG, Berlin, Germany at the time of study conduct, currently affiliated to Janssen Research and Development, Barcelona, Spain.
Cihan AyClinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Bernhard SchaeferBayer AG, Berlin, Germany.
Khaled AbdelgawwadBayer AG, Berlin, Germany.
George PsaroudakisBayer AG, Berlin, Germany.
Gunnar BrobertBayer AG, Berlin, Germany.
Anders EkbomUnit of Clinical Epidemiology, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
Agnes Y Y LeeDivision of Hematology, University of British Columbia and BC Cancer, Vancouver, Canada.
Alok A KhoranaCleveland Clinic and Case Comprehensive Cancer Center, Cleveland, Ohio, United States.ORCID 0000-0002-9509-0998
Cecilia BecattiniDepartment of Internal and Emergency Medicine - Stroke Unit, University of Perugia, Perugia, Italy.
Marc CarrierDepartment of Medicine, Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Canada.
Craig I ColemanDepartment of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs, Connecticut, United States.ORCID 0000-0003-4868-7158
Carlos MartinezInstitute for Epidemiology, Statistics and Informatics GmbH, Frankfurt am Main, Germany.ORCID 0000-0001-6498-6428
Bayer (Germany) · DECleveland Clinic · USJanssen (Germany) · DEKarolinska Institutet · SEMedical University of Vienna · ATSt Thomas' Hospital · GBUniversity of British Columbia · CAUniversity of Connecticut · USUniversity of Ottawa · CAUniversity of Perugia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn most patients with cancer-associated venous thromboembolism (CT), essentially those not at high risk of bleeding, guidelines recommend treatment with direct oral anticoagulants as an alternative to low-molecular-weight heparins (LMWHs). Population-based studies comparing these therapies are scarce.

objectivesTo compare the risk of venous thromboembolism (VTE) recurrences, significant bleeding, and all-cause mortality in patients with CT receiving rivaroxaban or LMWHs. PATIENTS/

methodsUsing UK Clinical Practice Research Datalink data from 2013 to 2020, we generated a cohort of patients with first CT treated initially with either rivaroxaban or LMWH. Patients were observed 12 months for VTE recurrences, significant bleeds (major bleeds or clinically relevant nonmajor bleeding requiring hospitalization), and all-cause mortality. Overlap weighted sub-distribution hazard ratios (SHRs) compared rivaroxaban with LMWH in an intention-to-treat analysis.

resultsThe cohort consisted of 2,259 patients with first CT, 314 receiving rivaroxaban, and 1,945 LMWH, mean age 72.4 and 66.9 years, respectively. In the 12-month observational period, 184 person-years following rivaroxaban and 1,057 following LMWH, 10 and 66 incident recurrent VTE events, 20 and 102 significant bleeds, and 10 and 133 deaths were observed in rivaroxaban and LMWH users, respectively. The weighted SHR at 12 months for VTE recurrences in rivaroxaban compared with LMWH were 0.80 (0.37-1.73); for significant bleeds 1.01 (0.57-1.81); and for all-cause mortality 0.49 (0.23-1.06).

conclusionPatients with CT, not at high risk of bleeding, treated with either rivaroxaban or LMWH have comparable effectiveness and safety outcomes. This supports the recommendation that rivaroxaban is a reasonable alternative to LMWH for the treatment of CT.

Indexed as

AnticoagulantsFactor Xa InhibitorsHeparin, Low-Molecular-WeightNeoplasmsRivaroxabanVenous ThromboembolismAgedAged, 80 and overFemaleHemorrhageHumansMaleMiddle AgedRecurrenceRisk FactorsTreatment OutcomeAnticoagulantsFactor Xa InhibitorsHeparin, Low-Molecular-WeightRivaroxaban

Identifiers

PMID38301711
PMCPMC11858610
OpenAlexW4391424613

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.