Evidence map›Paper›PMID 38735015›Full record

Observational studyJournal of thrombosis and thrombolysis2024

Comparison of rivaroxaban and low molecular weight heparin in the treatment of cancer-associated venous thromboembolism: a Swedish national population-based register study.

Marie Linder, Anders Ekbom, Gunnar Brobert, Kai Vogtländer, Yanina Balabanova, Cecilia Becattini, Marc Carrier, Alexander T Cohen, Craig I Coleman, Alok A Khorana and 6 more

Registry-linked trialAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of thrombosis and thrombolysis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05150938 (Observational Studies in Cancer Associated Thrombosis for Rivaroxaban in SwEden), which is not on this map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

NCT05150938 completednot on this map

Observational Studies in Cancer Associated Thrombosis for Rivaroxaban in SwEden (OSCAR-SE)

TypeobservationalSponsorBayerRan2022 to 2023Enrolled5,737ConditionsTreatment of Venous Thromboembolism in Cancer PatientsArmsRivaroxaban (Xarelto, BAY59-7939), Low molecular weight heparin (LMWH), vitamin K antagonist (VKA), other NOACs
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  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
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

16 authors.

Marie LinderDepartment of Medicine Solna, Clinical Epidemiology/ Centre for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. marie.linder@ki.se.ORCID http://orcid.org/0000-0003-2619-2189
Anders EkbomDepartment of Medicine Solna, Clinical Epidemiology/ Centre for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Gunnar BrobertConsultant for Bayer AG, Berlin, Germany.
Kai VogtländerBayer AG, Berlin, Germany.
Yanina BalabanovaBayer AG, Berlin, Germany.
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.
Alexander T CohenDepartment of Haematological Medicine, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK.
Craig I ColemanSchool of Pharmacy, University of Connecticut, Storrs, CT, USA.
Alok A KhoranaCleveland Clinic and Case Comprehensive Cancer Center, Cleveland, OH, USA.
Agnes Y Y LeeUniversity of British Columbia and BC Cancer, Vancouver, Canada.
George PsaroudakisBayer AG, Berlin, Germany.
Khaled AbdelgawwadBayer AG, Berlin, Germany.
Marcela RiveraConsultant for Bayer AG, Berlin, Germany.
Bernhard SchaeferBayer AG, Berlin, Germany.
Diego Hernan GiuntaDepartment of Medicine Solna, Clinical Epidemiology/ Centre for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreating cancer-associated venous thromboembolism (CAT) with anticoagulation prevents recurrent venous thromboembolism (rVTE), but increases bleeding risk.

objectivesTo compare incidence of rVTE, major bleeding, and all-cause mortality for rivaroxaban versus low molecular weight heparin (LMWH) in patients with CAT.

methodsWe developed a cohort study using Swedish national registers 2013-2019. Patients with CAT (venous thromboembolism within 6 months of cancer diagnosis) were included. Those with other indications or with high bleeding risk cancers were excluded (according to guidelines). Follow-up was from index-CAT until outcome, death, emigration, or end of study. Incidence rates (IR) per 1000 person-years with 95% confidence interval (CI) and propensity score overlap-weighted hazard ratios (HRs) for rivaroxaban versus LMWH were estimated.

resultsWe included 283 patients on rivaroxaban and 5181 on LMWH. The IR for rVTE was 68.7 (95% CI 40.0-109.9) for rivaroxaban, compared with 91.6 (95% CI 81.9-102.0) for LMWH, with adjusted HR 0.77 (95% CI 0.43-1.35). The IR for major bleeding was 23.5 (95% CI 8.6-51.1) for rivaroxaban versus 49.2 (95% CI 42.3-56.9) for LMWH, with adjusted HR 0.62 (95% CI 0.26-1.49). The IR for all-cause mortality was 146.8 (95% CI 103.9-201.5) for rivaroxaban and 565.6 (95% CI 541.8-590.2) for LMWH with adjusted HR 0.48 (95% CI 0.34-0.67).

conclusionsRivaroxaban performed similarly to LMWH for patients with CAT for rVTE and major bleeding. An all-cause mortality benefit was observed for rivaroxaban which potentially may be attributed to residual confounding. TRIAL REGISTRATION NUMBER: NCT05150938 (Registered 9 December 2021).

Indexed as

HemorrhageHeparin, Low-Molecular-WeightNeoplasmsRegistriesRivaroxabanVenous ThromboembolismAgedAnticoagulantsCohort StudiesFactor Xa InhibitorsFemaleHumansIncidenceMaleMiddle AgedSwedenAnticoagulantsFactor Xa InhibitorsHeparin, Low-Molecular-WeightRivaroxabanCancer-associated thrombosisLow molecular weight heparinMajor bleedingRecurrent venous thromboembolismRivaroxaban

Identifiers

PMID38735015
PMCPMC11315776

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Registered trials

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.