Evidence map›Paper›PMID 41797435›Full record

ArticleCancer2026

Risks of thrombosis and hemorrhage in concurrent use of anticoagulants and potential interacting prostate cancer agents.

Tzu-Fei Wang, Anna Clarke, Mitchell Rath, Samantha Yoo, Deena Fremont, Cynthia Wu, Pietro Ravani, Dominick Bossé, Robert Talarico, Marc Carrier and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2026. 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

11 authors.

Tzu-Fei WangDepartment of Medicine, University of Ottawa at The Ottawa Hospital and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID https://orcid.org/0000-0003-2407-9000
Anna ClarkeICES, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada.
Mitchell RathAlberta Health Services, Provincial Research and Data Services, University of Calgary, Calgary, Alberta, Canada.
Samantha YooICES, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada.
Deena FremontOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Cynthia WuDivision of Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Pietro RavaniDivision of Nephrology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Dominick BosséDepartment of Medicine, University of Ottawa at The Ottawa Hospital and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Robert TalaricoICES, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada.
Marc CarrierDepartment of Medicine, University of Ottawa at The Ottawa Hospital and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Manish M SoodDepartment of Medicine, University of Ottawa at The Ottawa Hospital and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Funding

CIHR 497263
6 · The paper itself

Abstract

backgroundPharmacokinetic studies suggest that specific prostate cancer therapies may alter the metabolism of direct oral anticoagulants (DOACs), leading to elevated risks of thrombosis or bleeding.

methodsTo assess the risk of thrombosis or bleeding, population-based, retrospective, parallel analyses were conducted in Ontario and Alberta, Canada, among adults patients with prostate cancer who were prescribed a DOAC and a potentially interacting androgen receptor pathway inhibitor (including enzalutamide, apalutamide, or abiraterone) compared with non-DOACs between 2012 and 2023. Analyses were stratified based on a DOAC-inducer cohort (enzalutamide or apalutamide, which might increase the risk of thrombosis) and a DOAC-inhibitor cohort (abiraterone, which might increase the risk of bleeding). Overlap weighted Cox proportional hazard models accounting for 37 covariates were performed independently in each jurisdiction and were pooled using random-effects meta-analysis.

resultsIn total, 2997 individuals were included (2107 from Ontario and 890 from Alberta). In patients who received enzalutamide or apalutamide, there was no increased risk of all thrombosis in the DOAC groups compared with the non-DOAC groups (pooled hazard ratio, 0.83; 95% confidence interval, 0.36-1.93). In patients who received abiraterone, no significant differences were observed in any bleeding events comparing the DOAC and non-DOAC groups (pooled hazard ratio, 1.16; 95% confidence interval, 0.10-13.99). The results were consistent in multiple sensitivity analyses.

conclusionsThe concurrent use of enzalutamide, apalutamide, or abiraterone with DOACs did not contribute to clinically meaningful changes in the risk of thrombosis or bleeding in individuals with prostate cancer.

Indexed as

AnticoagulantsAntineoplastic AgentsHemorrhageProstatic NeoplasmsThrombosisAgedAlbertaAndrostenesBenzamidesDrug InteractionsHumansMaleMiddle AgedNitrilesOntarioPhenylthiohydantoinabirateroneAndrostenesAnticoagulantsAntineoplastic AgentsapalutamideBenzamidesenzalutamideNitrilesPhenylthiohydantoinThiohydantoinsandrogen receptorsanticoagulantsdrug interactionshemorrhageprostatic neoplasmsthrombosis

Identifiers

PMID41797435
PMCPMC12968589

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.