The problematic propensity of people with cancer having a much higher risk for VTE has long presented clinical challenges that have been difficult to address. The use of oral edoxaban or rivaroxaban has been recommended for treatment of venous thromboembolism in patients with cancer, however the risk of bleeding linked to these medications has raised some concern. A multinational randomised controlled trial has assessed the efficacy of alternate options for treating cancer-associated venous thromboembolism. Patients with cancer and acute proximal deep-vein thrombosis or pulmonary embolism were randomly allocated to two treatment groups for six months; the first received oral apixaban (10 mg twice daily for 7 days, then 5 mg daily) and the second received subcutaneous dalteparin (200 IU/kg daily for one month, then 150 IU/kg daily). In the apixaban group (n = 576), recurrent venous thromboembolism occurred in 5.6%, while in the dalteparin group (n = 579), occurrence was 7.9%. Major bleeding in the apixaban and dalteparin groups was observed in 3.8% and 4.0% of cases respectively. These findings confirm that oral apixaban was more effective than subcutaneous dalteparin in treating venous thromboembolism in patients with cancer, without increasing the risk of major bleeding. Read details of the study here.
Contributed by AMSS Associate Isabella Singh