持续低分子量肝素与改用直接口服抗凝剂治疗癌症相关静脉血栓形成的有效性和安全性。
Effectiveness and safety of continuous low-molecular-weight heparin versus switching to direct oral anticoagulants in cancer-associated venous thrombosis.
发表日期：2024 Jul 05
作者：
Wei Kang, Caige Huang, Vincent K C Yan, Yue Wei, Jessica J P Shami, Silvia T H Li, Yu Yang, Xuxiao Ye, Junhan Tang, Shing Fung Lee, Victor H F Lee, Stephen L Chan, Aya El Helali, Ka On Lam, Roger K C Ngan, Ian C K Wong, Esther W Chan
来源：
CLINICAL PHARMACOLOGY & THERAPEUTICS
摘要：
鉴于癌症相关静脉血栓形成 (CAT) 患者从低分子量肝素 (LMWH) 转为直接口服抗凝剂 (DOAC) 的有效性和安全性存在不确定性，我们进行了一项基于人群的综合队列研究，利用香港电子健康数据库。共纳入 2010 年至 2022 年间 4356 名 CAT 患者，其中 1700 名（39.0%）患者转为 DOAC 治疗。与持续 LMWH 治疗相比，改用 DOAC 与因静脉血栓栓塞而住院的风险显着降低 (HR: 0.49 [95% CI = 0.35-0.68]) 和全因死亡率 (HR: 0.67 [95% CI = 0.61-0.74]），六个月内大出血没有显着差异（HR：1.04 [95% CI = 0.83-1.31]）。这些发现为 CAT 患者（包括弱势患者群体）从 LMWH 转换为 DOAC 的有效性和安全性提供了保证。© 2024。作者。
Given the existing uncertainty regarding the effectiveness and safety of switching from low-molecular-weight heparin (LMWH) to direct oral anticoagulants (DOACs) in patients with cancer-associated venous thrombosis (CAT), we conducted a comprehensive population-based cohort study utilizing electronic health database in Hong Kong. A total of 4356 patients with CAT between 2010 and 2022 were included, with 1700 (39.0%) patients switching to DOAC treatment. Compared to continuous LMWH treatment, switching to DOACs was associated with a significantly lower risk of hospitalization due to venous thromboembolism (HR: 0.49 [95% CI = 0.35-0.68]) and all-cause mortality (HR: 0.67 [95% CI = 0.61-0.74]), with no significant difference in major bleeding (HR: 1.04 [95% CI = 0.83-1.31]) within six months. These findings provide reassurance regarding the effectiveness and safety of switching from LMWH to DOACs among patients with CAT, including vulnerable patient groups.© 2024. The Author(s).