A prospective study of Rivaroxaban for central venous catheter associated upper extremity deep vein thrombosis in cancer patients (Catheter 2)

Studies in upper extremity deep vein thrombosis: Addressing the knowledge gaps

“…The authors aim to enroll 357 patients and plan to match the apixaban population with a historic cohort treated with warfarin. If successful, this will be the largest study assessing apixaban in this setting and will add to the scant existing information about the use of oral direct factor Xa inhibitors, together with a recently published study and another study currently ongoing (ClinicalTrials.gov identifier: NCT03100071). Most importantly, the study proposed by Woller and colleagues highlights the many voids that exist regarding our knowledge about UEDVT.…”

“…Regarding the safety of anticoagulation in patients with UEDVT, our recent meta‐analysis reported an overall occurrence of major bleeding events of 5%, although the data were limited by the use of different clinical definitions of bleeding, and all but 1 study used warfarin . To date, only 1 prospective study evaluating the use of rivaroxaban has been published in patients with UEDVT associated with catheters . This study reported 13% of bleeding events (8% major), most of them during the first 30 days, as well as 1 fatal pulmonary embolism while on treatment.…”

Managing thrombosis in cancer patients

“…A few single‐center cohort studies of rivaroxaban for CAT have yielded encouraging results, but all had significant methodologic limitations 40, 41, 42, 43. A recent study explored the use of rivaroxaban in cancer patients with catheter‐related thrombosis also had promising results 44. Overall, these preliminary results are encouraging, but not definitive.…”

“…The CATHETER 2 study further explored the use of DOAC in this condition. They treated 70 cancer patients and CRT with rivaroxaban, and found that at 12 weeks, the line preservation rate was 100%, with a rate of recurrent VTE of 1.43% and a major bleeding rate of 10% 44. Both studies were single arm intervention without controls, and cross trial comparisons cannot be made.…”

“…[40][41][42][43] A recent study explored the use of rivaroxaban in cancer patients with catheter-related thrombosis also had promising results. 44 The results of another study of this kind, the Select-D pilot trial, were also recently reported as in the abstract format. 47 Figure 2A), but increase the risk of major bleeding (RR 1.74, 95% CI 1.05-2.88, Figure 2B).…”