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Effectiveness and safety of continuous low-molecular-weight heparin versus switching to direct oral anticoagulants in cancer-associated venous thrombosis

Author

Listed:
  • Wei Kang

    (The University of Hong Kong)

  • Caige Huang

    (The University of Hong Kong)

  • Vincent K. C. Yan

    (The University of Hong Kong)

  • Yue Wei

    (The University of Hong Kong)

  • Jessica J. P. Shami

    (The University of Hong Kong)

  • Silvia T. H. Li

    (The University of Hong Kong)

  • Yu Yang

    (The University of Hong Kong)

  • Xuxiao Ye

    (The University of Hong Kong)

  • Junhan Tang

    (The University of Hong Kong)

  • Shing Fung Lee

    (National University Hospital
    National University of Singapore)

  • Victor H. F. Lee

    (The University of Hong Kong
    The University of Hong Kong-Shenzhen Hospital)

  • Stephen L. Chan

    (The Chinese University of Hong Kong)

  • Aya El Helali

    (The University of Hong Kong)

  • Ka On Lam

    (The University of Hong Kong
    The University of Hong Kong-Shenzhen Hospital)

  • Roger K. C. Ngan

    (The University of Hong Kong)

  • Ian C. K. Wong

    (The University of Hong Kong
    Hong Kong Science and Technology Park
    Aston University
    Macau University of Science and Technology)

  • Esther W. Chan

    (The University of Hong Kong
    Hong Kong Science and Technology Park
    The University of Hong Kong Shenzhen Institute of Research and Innovation
    The University of Hong Kong-Shenzhen Hospital)

Abstract

Given the existing uncertainty regarding the effectiveness and safety of switching from low-molecular-weight heparin (LMWH) to direct oral anticoagulants (DOACs) in patients with cancer-associated venous thrombosis (CAT), we conducted a comprehensive population-based cohort study utilizing electronic health database in Hong Kong. A total of 4356 patients with CAT between 2010 and 2022 were included, with 1700 (39.0%) patients switching to DOAC treatment. Compared to continuous LMWH treatment, switching to DOACs was associated with a significantly lower risk of hospitalization due to venous thromboembolism (HR: 0.49 [95% CI = 0.35–0.68]) and all-cause mortality (HR: 0.67 [95% CI = 0.61–0.74]), with no significant difference in major bleeding (HR: 1.04 [95% CI = 0.83–1.31]) within six months. These findings provide reassurance regarding the effectiveness and safety of switching from LMWH to DOACs among patients with CAT, including vulnerable patient groups.

Suggested Citation

  • Wei Kang & Caige Huang & Vincent K. C. Yan & Yue Wei & Jessica J. P. Shami & Silvia T. H. Li & Yu Yang & Xuxiao Ye & Junhan Tang & Shing Fung Lee & Victor H. F. Lee & Stephen L. Chan & Aya El Helali &, 2024. "Effectiveness and safety of continuous low-molecular-weight heparin versus switching to direct oral anticoagulants in cancer-associated venous thrombosis," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-50037-1
    DOI: 10.1038/s41467-024-50037-1
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