Evidence map›Paper›PMID 39432236›Full record

SynthesisCardiovascular drugs and therapy2025

Clinical Efficacy and Safety of Novel Anticoagulants for the Management of Venous Thromboembolism in Patients with Cancer: A Systematic Review and Meta-Analysis.

Mei-Chuan Lee, Jheng-Yan Wu, Tsung Yu, Chia-Te Liao, Wei-Ting Chang, Han Siong Toh, Kuo-Chuan Hung, Hui-Chen Su

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular drugs and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

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

1 citing paper in PubMed.

  1. 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

8 authors.

Mei-Chuan LeeDepartment of Pharmacy, Chi-Mei Medical Center, No 901, Zhonghua Rd, Yong Kang District, Tainan City, Taiwan.
Jheng-Yan WuDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Tsung YuDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Chia-Te LiaoDivision of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
Wei-Ting ChangDivision of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
Han Siong TohDepartment of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Kuo-Chuan HungDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Hui-Chen SuDepartment of Pharmacy, Chi-Mei Medical Center, No 901, Zhonghua Rd, Yong Kang District, Tainan City, Taiwan. michael.maggil@gmail.com.ORCID 0000-0002-6532-1169

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCancer patients face a four- to sevenfold higher risk of venous thromboembolism (VTE) than the general population. Novel oral anticoagulants (NOACs) provide convenient alternatives to traditional therapies.

methodsWe performed a systematic literature search across PubMed, Embase, and the Cochrane Library, targeting studies that examined the use of NOACs in cancer-associated VTE. The search included randomized controlled trials (RCTs). Selected studies compared NOACs with low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKA) in cancer patients diagnosed with VTE. A meta-analysis using a random-effects model was applied to estimate pooled effect sizes for outcomes.

resultsIn this meta-analysis, we included 12 RCTs. Results showed NOACs were more effective than LMWH in preventing VTE recurrence (RR 0.66, 95% CI 0.52-0.83, p = 0.0004). Compared with VKAs, NOACs showed no significant difference (RR 0.63, 95% CI 0.34-1.15, p = 0.13). However, this finding is limited by the small patient sample. Major bleeding outcomes were similar between NOACs and LMWH/VKAs (RR 1.24, 95% CI 0.85-1.80, p = 0.28; RR 0.77, 95% CI 0.39-1.53, p = 0.46, respectively). Meta-regression analysis indicated a statistically significant positive correlation between mortality and major bleeding events when comparing NOACs with LMWH (p = 0.049). There was no significant difference in all-cause mortality between patients treated with NOACs and those treated with LMWH (RR 1.04, 95% CI 0.92-1.18, p = 0.54) or VKAs (RR 0.94, 95% CI 0.72-1.23, p = 0.65).

conclusionMeta-analysis shows NOACs, especially factor Xa inhibitors, reduce VTE recurrence in cancer patients more effectively than LMWH. Comparison between NOACs and VKAs is inconclusive due to limited patient data. Further research is needed to assess NOACs' efficacy and safety against VKAs.

Indexed as

AnticoagulantsNeoplasmsVenous ThromboembolismAdministration, OralHemorrhageHeparin, Low-Molecular-WeightHumansRandomized Controlled Trials as TopicTreatment OutcomeAnticoagulantsHeparin, Low-Molecular-WeightAnticoagulantCancer-associated VTENOACsVTE

Identifiers

PMID39432236

What OpenQuestion holds

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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.