Meta-analysis of the efficacy and safety of novel oral anticoagulants in the treatment of venous thromboembolism in cancer patients
- VernacularTitle:新型口服抗凝剂治疗癌症患者静脉血栓栓塞有效性及安全性的Meta分析
- Author:
Zuxiu WANG
1
;
Xuhuan LI
1
;
Peimeng YOU
2
;
Tingde ZHU
1
;
Lixu CHEN
1
;
Yiqun YAN
3
;
Yongping PAN
1
Author Information
1. Dept. of General Medicine，the Fourth Affiliated Hospital of Nanchang University，Nanchang 330003，China
2. Dept. of Chest Tumor Radiotherapy，Jiangxi Cancer Hospital，Nanchang 330029，China
3. Dept. of General Medicine，Jiangxi Cancer Hospital，Nanchang 330029，China
- Publication Type:Journal Article
- Keywords:
cancer;
venous thromboembolism;
anticoa-
- From:
China Pharmacy
2024;35(7):842-847
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of novel oral anticoagulants （NOAC） in the treatment of cancer-related venous thromboembolism （VTE） patients. METHODS Retrieved from PubMed， Cochrane Library， Embase， Web of Science， CNKI， and Wanfang database from the establishment of each database to August， 2023， randomized controlled trials （RCTs） about the efficacy of low-molecular-weight heparin （LMWH， control group） versus NOAC （trial group） in the treatment of cancer-related VTE patients were collected. After extracting the data from included clinical studies， meta-analysis was performed by using RevMan 5.0 statistical software. RESULTS A total of 7 RCTs were included， with a total of 3 790 patients. Compared with the control group， the recurrence rate of VTE in the trial group was significantly reduced （RR＝0.65， 95%CI 0.51-0.82， P＝0.000 4）， while the incidence of major bleeding was slightly higher than in the control group， but the difference was not statistically significant （RR＝1.13， 95%CI 0.83-1.53， P＝0.45）. The incidence of clinically relevant non-major bleeding （RR＝1.69， 95%CI 1.34-2.13， P＜0.000 01） and gastrointestinal bleeding （RR＝1.96， 95%CI 1.15-3.34， P＝0.01） in the trial group was significantly higher than in the control group. There was no statistically significant difference in the incidence of intracranial hemorrhage， all-cause mortality， and fatal pulmonary embolism between 2 groups （P＞0.05）. CONCLUSIONS For cancer-related VTE patients， NOAC is superior to LMWH in preventing venous thrombosis recurrence， and is not inferior to LMWH in terms of major bleeding， intracranial hemorrhage， all-cause mortality， and fatal pulmonary embolism.
