Comparison of the effects of edoxaban, an oral direct factor Xa inhibitor, on venous thromboembolism between patients with and without cancer.
Comparison of the effects of edoxaban, an oral direct factor Xa inhibitor, on venous thromboembolism between patients with and without cancer.
复制标题
比较艾多沙班（一种口服直接 Xa 因子抑制剂）对癌症患者和非癌症患者静脉血栓栓塞的影响。
DOI：
10.1016/j.jjcc.2018.03.006
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发表时间：
2018
期刊：
影响因子：
2.5
通讯作者：
Maemura K.
中科院分区：
文献类型：
--
作者：
Ikeda S;Koga S;Yamagata Y;Eguchi M;Sato D;Muroya T;Yonekura T;Tsuneto A;Yoshimuta T;Koide Y;Kawano H; Maemura K.
背景静脉血栓栓塞（VTE）是恶性肿瘤常见的严重并发症.美国和欧洲的现行指南建议使用低分子量肝素（LMWH）治疗癌症相关性VTE。在日本，LMWH不用于治疗VTE;相反，依度沙班（一种口服直接Xa因子抑制剂）于2014年9月获批用于治疗VTE。然而，Xa因子抑制剂在癌症patients.MethodsPatients的图表进行了回顾性分析，并在2014年9月和2016年9月之间开始edoxaban治疗的125 VTE患者（61例癌症患者）被纳入本研究的有效性和安全性尚未完全阐明。患者的人口统计学，静脉血栓栓塞量，静脉血栓栓塞复发，临床相关的出血，和结果，直到2017年2月进行了检查。ResultsPatients的特征，包括年龄，性别，体重，肌酐清除率，edoxaban的管理持续时间是癌症和非癌症患者之间的可比性。分别有37.5%和55.7%的非癌症和癌症患者在依度沙班之前未接受过肠外抗凝治疗。两组肺栓塞的发生率也相似。在接受至少两次影像学检查的非癌症和癌症患者中，分别有89.6%和94.1%的血栓形成量减少（“改善”）或消失（“正常化”）。两组之间VTE复发和临床相关出血的频率无显著差异（分别为p= 0.414和0.516）。然而，21例癌症患者死亡，其中17人死于癌症，而没有非癌症患者deaths.ConclusionThe本研究表明，疗效和安全性edoxaban治疗静脉血栓栓塞是癌症和非癌症患者之间的可比性。依度沙班可能是日本癌症患者VTE的临床有效治疗方法。
BackgroundVenous thromboembolism (VTE) is a frequent and serious complication of cancer. The current guidelines in the USA and Europe recommend low-molecular weight heparin (LMWH) for the treatment of cancer-associated VTE. In Japan, LMWH is not given for the treatment of VTE; instead edoxaban, an oral direct factor Xa inhibitor, was approved for the treatment of VTE in September 2014. However, the efficacy and safety of the factor Xa inhibitor in cancer patients have not been fully elucidated.MethodsPatients’ charts were reviewed retrospectively, and 125 VTE patients (61 cancer patients) in whom edoxaban therapy was started between September 2014 and September 2016 were included in this study. Patients’ demographics, changes in VTE amount, VTE recurrence, clinically relevant bleeding, and outcomes until February 2017 were examined.ResultsPatients’ characteristics, including age, sex, weight, creatinine clearance, and duration of administration of edoxaban were comparable between cancer and non-cancer patients. No parenteral anticoagulant pretreatment before edoxaban was given in 37.5% and 55.7% of non-cancer and cancer patients, respectively. The incidence of pulmonary embolism was also similar in the two groups. The amount of thrombosis decreased (“improved”) or disappeared (“normalized”) in 89.6% and 94.1%, respectively, of non-cancer and cancer patients who underwent at least two imaging tests. The frequencies of recurrence of VTE and clinically relevant bleeding were not significantly different between the two groups (p= 0.414 and 0.516, respectively). However, 21 cancer patients died, 17 of whom died of cancer, while none of the non-cancer patients died.ConclusionThe present study showed that the efficacy and safety of edoxaban for the treatment of VTE is comparable between cancer and non-cancer patients. Edoxaban may be a clinically useful therapy for VTE in Japanese cancer patients.