Anticoagulation for the intial treatment of venous thromboembolism in patients with cancer

Evaluating prophylactic heparin in ambulatory patients with solid tumours: a systematic review and individual participant data meta-analysis

“…(9) These observations led to numerous trials evaluating the role of heparins in cancer survival, while subsequent systematic reviews and guideline panels began to evaluate the benefits and harms of prophylactic heparin use in patients with solid tumors. (10)(11)(12)(13)(14)(15) Our previous study level meta-analyses suggested a survival benefit and a large reduction in VTE in favour of heparins. (4,16) However, study level meta-analyses have limitations which include not allowing in-depth exploration of subgroup effects.…”

Evaluating prophylactic heparin in ambulatory patients with solid tumours: a systematic review and individual participant data meta-analysis

“…(9) These observations led to numerous trials evaluating the role of heparins in cancer survival, while subsequent systematic reviews and guideline panels began to evaluate the benefits and harms of prophylactic heparin use in patients with solid tumors. (10)(11)(12)(13)(14)(15) Our previous study level meta-analyses suggested a survival benefit and a large reduction in VTE in favour of heparins. (4,16) However, study level meta-analyses have limitations which include not allowing in-depth exploration of subgroup effects.…”

Anticoagulation for prevention and treatment of cancer‐related venous thromboembolism

“…However, a recent Cochrane meta‐analysis included seven randomised clinical trials comparing LMWH to oral vitamin K antagonists for the long‐term secondary prophylaxis of cancer‐related VTE. This did not demonstrate a statistically significant survival benefit with LMWH (HR 0·96; 95% CI, 0·81–1·14) (Akl et al , ).…”

“…Major bleeding was more frequent in patients receiving warfarin (2·1% vs. 0%) but most bleeding events were minor and these occurred with the same frequency in both groups (Hull et al , ) (Table ). In a recent Cochrane meta‐analysis of seven RCTs involving cancer patients with VTE, there was a significant reduction in VTE recurrence in the patients treated with LMWH compared to those treated with oral vitamin K antagonists (HR 0·47; 95% CI, 0·32–0·71) (Akl et al , ).…”

Wytyczne leczenia i profilaktyki żylnej choroby zatorowo-zakrzepowej u chorych onkologicznych leczonych operacyjnie z uwzględnieniem chorych poniżej 18. roku życia

“…A Cochrane meta-analysis published by Akl et al [233], based on the evaluation of the results of 7 prospective RCTs comparing LMWH treatment with extended oral VKA treatment, a statistically significant, almost 50% reduction in the risk of VTE recurrence was shown in the group treated with LMWH (HR 0.47; 95% CI 0.32-0.71), with a comparable risk of major and minor bleeding complications in both groups of patients. Similar conclusions indicating a significant reduction of the risk of VTE recurrence and no effect on the increase of bleeding events in cancer patients receiving extended treatment with LMWH can be found in the previously published meta-analysis by Louzad et al [234].…”

Evaluating prophylactic heparin in ambulatory patients with solid tumours: a systematic review and individual participant data meta-analysis

“…(9) These observations led to numerous trials evaluating the role of heparins in cancer survival, while subsequent systematic reviews and guideline panels began to evaluate the benefits and harms of prophylactic heparin use in patients with solid tumors. (10)(11)(12)(13)(14)(15) Our previous study level meta-analyses suggested a survival benefit and a large reduction in VTE in favour of heparins. (4,16) However, study level meta-analyses have limitations which include not allowing in-depth exploration of subgroup effects.…”

Anticoagulation for prevention and treatment of cancer‐related venous thromboembolism

“…However, a recent Cochrane meta‐analysis included seven randomised clinical trials comparing LMWH to oral vitamin K antagonists for the long‐term secondary prophylaxis of cancer‐related VTE. This did not demonstrate a statistically significant survival benefit with LMWH (HR 0·96; 95% CI, 0·81–1·14) (Akl et al , ).…”

“…Major bleeding was more frequent in patients receiving warfarin (2·1% vs. 0%) but most bleeding events were minor and these occurred with the same frequency in both groups (Hull et al , ) (Table ). In a recent Cochrane meta‐analysis of seven RCTs involving cancer patients with VTE, there was a significant reduction in VTE recurrence in the patients treated with LMWH compared to those treated with oral vitamin K antagonists (HR 0·47; 95% CI, 0·32–0·71) (Akl et al , ).…”

Wytyczne leczenia i profilaktyki żylnej choroby zatorowo-zakrzepowej u chorych onkologicznych leczonych operacyjnie z uwzględnieniem chorych poniżej 18. roku życia

“…A Cochrane meta-analysis published by Akl et al [233], based on the evaluation of the results of 7 prospective RCTs comparing LMWH treatment with extended oral VKA treatment, a statistically significant, almost 50% reduction in the risk of VTE recurrence was shown in the group treated with LMWH (HR 0.47; 95% CI 0.32-0.71), with a comparable risk of major and minor bleeding complications in both groups of patients. Similar conclusions indicating a significant reduction of the risk of VTE recurrence and no effect on the increase of bleeding events in cancer patients receiving extended treatment with LMWH can be found in the previously published meta-analysis by Louzad et al [234].…”

Evaluating prophylactic heparin in ambulatory patients with solid tumours: a systematic review and individual participant data meta-analysis

“…(9) These observations led to numerous trials evaluating the role of heparins in cancer survival, while subsequent systematic reviews and guideline panels began to evaluate the benefits and harms of prophylactic heparin use in patients with solid tumors. (10)(11)(12)(13)(14)(15) Our previous study level meta-analyses suggested a survival benefit and a large reduction in VTE in favour of heparins. (4,16) However, study level meta-analyses have limitations which include not allowing in-depth exploration of subgroup effects.…”

Anticoagulation for prevention and treatment of cancer‐related venous thromboembolism

“…However, a recent Cochrane meta‐analysis included seven randomised clinical trials comparing LMWH to oral vitamin K antagonists for the long‐term secondary prophylaxis of cancer‐related VTE. This did not demonstrate a statistically significant survival benefit with LMWH (HR 0·96; 95% CI, 0·81–1·14) (Akl et al , ).…”

“…Major bleeding was more frequent in patients receiving warfarin (2·1% vs. 0%) but most bleeding events were minor and these occurred with the same frequency in both groups (Hull et al , ) (Table ). In a recent Cochrane meta‐analysis of seven RCTs involving cancer patients with VTE, there was a significant reduction in VTE recurrence in the patients treated with LMWH compared to those treated with oral vitamin K antagonists (HR 0·47; 95% CI, 0·32–0·71) (Akl et al , ).…”

Wytyczne leczenia i profilaktyki żylnej choroby zatorowo-zakrzepowej u chorych onkologicznych leczonych operacyjnie z uwzględnieniem chorych poniżej 18. roku życia

“…A Cochrane meta-analysis published by Akl et al [233], based on the evaluation of the results of 7 prospective RCTs comparing LMWH treatment with extended oral VKA treatment, a statistically significant, almost 50% reduction in the risk of VTE recurrence was shown in the group treated with LMWH (HR 0.47; 95% CI 0.32-0.71), with a comparable risk of major and minor bleeding complications in both groups of patients. Similar conclusions indicating a significant reduction of the risk of VTE recurrence and no effect on the increase of bleeding events in cancer patients receiving extended treatment with LMWH can be found in the previously published meta-analysis by Louzad et al [234].…”