J Thromb Haemost:静脉血栓栓塞的癌症患者接受艾多沙班延长治疗的疗效

2019-07-08 xing.T MedSci原创

由此可见,在接受超过6个月的延长抗凝治疗的活动性癌症患者中,复发性VTE或大出血的发生率相对较低。口服艾多沙班的延长治疗似乎与皮下注射达肝素一样有效和安全。

活动性癌症和静脉血栓栓塞(VTE)患者具有较高的复发风险。因此,在该患者群体中建议持续超过6个月的抗凝治疗,但支持该方法的证据有限。 

近日,血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,Hokusai VTE癌症试验将用于活动性癌症患者的VTE治疗的艾多沙班与达肝素进行比较。该事后分析侧重于6至12个月的随访期。主要结局是判定的首次复发性VTE或大出血的复合事件。次要结局包括复发性VTE、大出血和临床相关出血。 

在随机分配到艾多沙班或达肝素的522名和524名患者中,分别有294名(56%)接受了艾多沙班和273名(52%)接受了达肝素治疗超过6个月(中位持续时间分别为318和211天)。在6至12个月之间,研究治疗期间的主要结局发生在艾多沙班组有7名患者(2.4%)和达肝素组有6名患者(2.2%)(未调整的风险比为1.05; 95%CI为0.36至3.05)。艾多沙班组有2例患者(0.7%)和达肝素组3例患者(1.1%)发生复发性VTE,而分别有5例(1.7%)和3例(1.1%)患者出现大出血。

由此可见,在接受超过6个月的延长抗凝治疗的活动性癌症患者中,复发性VTE或大出血的发生率相对较低。口服艾多沙班的延长治疗似乎与皮下注射达肝素一样有效和安全。 

原始出处:

Marcello Di Nisio.et al.Extended treatment with edoxaban in cancer patients with venous thromboembolism: a post‐hoc analysis of the Hokusai‐VTE Cancer study.Journal of Thrombosis and Haemostasis.2019.https://doi.org/10.1111/jth.14561

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1697930, encodeId=caf6169e930c1, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Thu Mar 12 21:12:00 CST 2020, time=2020-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955438, encodeId=0f431955438f1, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sun Feb 16 03:12:00 CST 2020, time=2020-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008429, encodeId=662b2008429b6, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Thu Aug 08 07:12:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289643, encodeId=16e31289643eb, content=<a href='/topic/show?id=cbb8e1356f7' target=_blank style='color:#2F92EE;'>#癌症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71356, encryptionId=cbb8e1356f7, topicName=癌症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=10ba218, createdName=zgwhgch, createdTime=Wed Jul 10 12:12:00 CST 2019, time=2019-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369350, encodeId=005b369350ac, content=口服艾多沙班的延长治疗似乎与皮下注射达肝素一样有效和安全。, beContent=null, objectType=article, channel=null, level=null, likeNumber=178, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jul 09 10:01:22 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032218, encodeId=231d10322184c, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 09 00:12:00 CST 2019, time=2019-07-09, status=1, ipAttribution=)]
    2020-03-12 fusion

    #静脉#

    0

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    2020-02-16 xue8602
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    2019-08-08 changfy

    #HAE#

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    2019-07-10 zgwhgch
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    2019-07-09 cqykthl

    口服艾多沙班的延长治疗似乎与皮下注射达肝素一样有效和安全。

    0

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    2019-07-09 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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