Background: The management of recurrent venous thromboembolism (VTE) despite anticoagulant treatment in patients with cancer is uncertain. To address this, we used data from the Hokusai VTE Cancer trial, which compared edoxaban with dalteparin to treat cancer-associated VTE.
Methods: In this post-hoc analysis, we characterized and evaluated anticoagulant treatment strategies during and after on-treatment recurrent VTE, including the type and dose of anticoagulant. All patients with adjudicated on-treatment recurrent VTE within 12 months after randomization were included. Outcomes were second recurrent VTE and major bleeding within 3 months after the first recurrent VTE.
Results: A total of 67 patients developed on-treatment recurrent VTE while receiving therapeutic-dose edoxaban (31%), therapeutic-dose low-molecular-weight heparin (LMWH) (34%), maintenance-dose LMWH (21%), or other therapies (14%). After the recurrent event, 28 patients (42%) received an increased dose, 35 (52%) a comparable dose, and 4 (6%) a reduced dose or stopped anticoagulants. Common treatment regimens included supratherapeutic-dose LMWH (21%), therapeutic-dose LMWH (51%), DOAC (16%), or another treatment strategy (12%). In the 3 months after recurrent VTE, 6 (9%) patients had a second recurrence, and 7 (10%) had major bleeding.
Conclusions: Treatment strategies for recurrent VTE in patients with cancer are heterogeneous. The risk of a second recurrence and major bleeding are considerable. More studies are needed to determine the optimal treatment strategy for recurrent cancer-associated thrombosis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtha.2025.02.022 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Statins as an Adjunctive Antithrombotic Agent in Thrombotic Antiphospholipid Syndrome: Mechanisms and Clinical Implications.
Cells
February 2025
Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy.
The thrombotic physiopathology of antiphospholipid syndrome (APS) is complex, heterogeneous, and dynamic. While venous thromboembolism (VTE) is the most common initial presentation, arterial thrombotic events (ATE) become more frequent in advanced stages and are associated with high morbidity and mortality. Despite the use of oral anticoagulants (OACs), thrombotic APS remains associated with a high risk of recurrent thrombosis.
View Article and Find Full Text PDFA Rare Case of Postpartum Portal Vein Thrombosis in a Young Patient With Heterozygous Prothrombin G20210A Mutation.
Cureus
February 2025
Internal Medicine, Lebanese University Faculty of Medical Sciences, Beirut, LBN.
Portal vein thrombosis (PVT) is most commonly associated with cirrhosis due to the reduced blood flow through the liver. However, its occurrence in non-cirrhotic individuals is rare and typically linked to hypercoagulable states. The postpartum period is a recognized hypercoagulable state, yet PVT in this context remains uncommon.
View Article and Find Full Text PDFThe role of controlling nutritional status score in predicting postthrombotic syndrome in patients with lower extremity deep venous thrombosis.
Thromb J
March 2025
Department of Ultrasound, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, 315010, Zhejiang, China.
This study aimed to explore the efficacy of Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT), and Nutritional Risk Index (NRI) in predicting postthrombotic syndrome (PTS) in patients with lower extremity deep vein thrombosis (DVT) based on peripheral blood samples. We reviewed and analyzed patients with lower extremity DVT in our hospital from June 2020 to December 2023. The receiver operating characteristic (ROC) curve identified the best nutritional scoring system for a logistic regression model.
View Article and Find Full Text PDFTreatment and outcomes after on-treatment recurrent venous thromboembolism in patients with cancer: a post-hoc analysis of the Hokusai VTE Cancer study.
J Thromb Haemost
March 2025
Department of Medicine, University of Ottawa at The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Background: The management of recurrent venous thromboembolism (VTE) despite anticoagulant treatment in patients with cancer is uncertain. To address this, we used data from the Hokusai VTE Cancer trial, which compared edoxaban with dalteparin to treat cancer-associated VTE.
Methods: In this post-hoc analysis, we characterized and evaluated anticoagulant treatment strategies during and after on-treatment recurrent VTE, including the type and dose of anticoagulant.
Relationship between Surgery and Trauma and Risk of Recurrence in Patients with an Associated First Venous Thrombotic Event: A Nested Case-Control Study.
Thromb Haemost
March 2025
Thrombosis and Haemostasis Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom.
The duration of anticoagulation treatment for venous thromboembolism (VTE) depends on whether the event was provoked or unprovoked. Major surgery or trauma are well-established major provoking factors associated with a low risk of recurrence, but the magnitude of risk with VTE after minor surgery or trauma is uncertain.To compare the rate of recurrence in patients with VTE provoked by minor surgery or trauma with that in patients with VTE provoked by major surgery or trauma.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!