Anticoagulation for the Treatment of Cancer-Associated Thrombosis: A Systematic Review and Network Meta-Analysis of Randomized Trials

Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Diana M SobierajCraig I Coleman

Abstract

To perform a systematic review and network meta-analysis evaluating the efficacy and safety of low-molecular-weight heparins (LMWHs), vitamin K antagonists (VKAs), and direct-acting oral anticoagulants (DOACs) for the treatment of cancer-associated thrombosis (CAT). We searched MEDLINE, Cochrane Central Register of Controlled Trials, and conference abstracts through March 2018. Randomized controlled trials (RCTs) enrolling adults with CAT comparing 2 or more full-dose anticoagulants (LMWH, VKA, and DOAC) and evaluating recurrent venous thromboembolism (VTE), major bleeding, and/or all-cause mortality were included. Reviewers identified studies, extracted data, and assessed the quality of the evidence in duplicate. A frequentist network meta-analysis, which uses direct and indirect evidence to simultaneously compare multiple interventions, was performed using a random-effects approach. Results are reported as pooled relative risks (RRs) with 95% confidence intervals (CIs). We included 13 RCTs (n = 6292): 7 compared LMWHs with VKAs, 4 compared DOACs with VKAs, and 2 compared DOACs with LMWHs. The risk of recurrent VTE was significantly reduced by 28% and 54% with a DOAC compared to an LMWH and a VKA, respectively. Low-molecular-w...Continue Reading

References

Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Jul 11, 2003·The New England Journal of Medicine·Agnes Y Y LeeUNKNOWN Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Veno
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Feb 11, 2005·JAMA : the Journal of the American Medical Association·Jeanet W BlomFrits R Rosendaal
Sep 27, 2006·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Steven R DeitcherUNKNOWN ONCENOX Investigators
Dec 6, 2006·The American Journal of Medicine·Russell D HullUNKNOWN LITE Trial Investigators
Jan 6, 2009·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A RomeraO Lapiedra
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Jul 12, 2013·Blood·Agnes Y Y Lee, Erica A Peterson
Jan 22, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gary H LymanUNKNOWN American Society of Clinical Oncology
Jul 17, 2015·Haemophilia : the Official Journal of the World Federation of Hemophilia·C Chai-AdisaksophaA Iorio
Aug 1, 2015·BMC Medical Research Methodology·Gerta Rücker, Guido Schwarzer
Aug 19, 2015·JAMA : the Journal of the American Medical Association·Agnes Y Y LeeUNKNOWN CATCH Investigators
Sep 27, 2015·Journal of Thrombosis and Haemostasis : JTH·G AgnelliT Yamabe
Sep 15, 2016·Thrombosis and Haemostasis·Miriam Bach, Rupert Bauersachs
Oct 6, 2017·Research Synthesis Methods·Gerta Rücker, Guido Schwarzer
Dec 13, 2017·The New England Journal of Medicine·Gary E RaskobUNKNOWN Hokusai VTE Cancer Investigators
Feb 6, 2018·American Journal of Hematology·Michael B StreiffAlok A Khorana
May 11, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Annie M YoungMark Levine

❮ Previous
Next ❯

Citations

Nov 24, 2018·Journal of Thrombosis and Thrombolysis·A Franco-MorenoM García-Navarro
May 11, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Samuel DubinskyUrban Emmenegger
Jun 22, 2020·Herz·Martina-Elisabeth SpehlmannOliver J Müller
Apr 25, 2020·Current Treatment Options in Oncology·Tulsi Patel, David A Iglesias
Apr 30, 2020·BMC Cardiovascular Disorders·Isabela B S da S CostaLudhmila Abrahao Hajjar
May 18, 2019·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·George I KirkilesisIoannis A Tsolakis

❮ Previous
Next ❯

Software Mentioned

OVID
netmeta
R
meta

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.