Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis

Prandoni, Paolo; Lensing, Anthonie W. A.; Piccioli, Andrea; Bernardi, Enrico; Simioni, Paolo; Girolami, Bruno; Marchiori, Antonio; Sabbion, Paola; Prins, Martin H.; Noventa, Franco; Girolami, Antonio

doi:10.1182/blood-2002-01-0108

Cited by 1,654 publications

(1,320 citation statements)

References 32 publications

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“…In a phase II study, coadministration of low‐dose ASA (100 mg), high‐dose ASA (325 mg), and naproxen with edoxaban increased bleeding time 21. Patients with cancer also experience high risk of anticoagulant‐associated major bleeding 22, 23…”

Section: Discussionmentioning

confidence: 99%

Edoxaban Exposure‐Response Analysis and Clinical Utility Index Assessment in Patients With Symptomatic Deep‐Vein Thrombosis or Pulmonary Embolism

Nyberg

Karlsson

Jönsson

et al. 2016

CPT Pharmacom & Syst Pharma

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Edoxaban exposure‐response relationships from the phase III study evaluating edoxaban for prevention and treatment of venous thromboembolism (VTE) in patients with acute deep vein thrombosis (DVT) and/or pulmonary embolism (PE) were assessed by parametric time‐to‐event analysis. Statistical significant exposure‐response relationships were recurrent VTE with hazard ratio (HR) based on average edoxaban concentration at steady state (Cav) (HRCav) = 0.98 (i.e., change in the HR with every 1 ng/mL increase of Cav); the composite of recurrent DVT and nonfatal PE with HRCav = 0.99; and the composite of recurrent DVT, nonfatal PE, and all‐cause mortality HRCav = 0.98, and all death using maximal edoxaban concentration (Cmax) with HR (Cmax) = 0.99. No statistical significant exposure‐response relationships were found for clinically relevant bleeding or major adverse cardiovascular event. Results support the recommendation of once‐daily edoxaban 60 mg, and a reduced 30 mg dose in patients with moderate renal impairment, body weight ≤60 kg, or use of P‐glycoprotein inhibitors verapamil or quinidine.

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Section: Discussionmentioning

confidence: 99%

Edoxaban Exposure‐Response Analysis and Clinical Utility Index Assessment in Patients With Symptomatic Deep‐Vein Thrombosis or Pulmonary Embolism

Nyberg

Karlsson

Jönsson

et al. 2016

CPT Pharmacom & Syst Pharma

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“…The first two events occurred while the patients were on full dose, the latter on lower dose Fragmin. Cancer patients receiving anticoagulation therapy have a substantially increased risk of bleeding, of the order of 12% per year of treatment, compared with patients with nonmalignant disease (Prandoni et al, 2002). In the only published randomised study comparing prolonged LMWH treatment with conventional anticoagulation, the risk of bleeding with 3 months of LMWH treatment was lower than with warfarin therapy in patients with deep vein thrombosis (Pini et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

Combination antiangiogenesis therapy with marimastat, captopril and fragmin in patients with advanced cancer

et al. 2004

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Marimastat, low molecular weight heparins and captopril have antiangiogenic activity in vitro and in animal models. We studied the safety and efficacy of the combination of these drugs in patients with advanced cancer. In all, 50 patients were enrolled. Captopril was given orally at a dose of 50 mg bd daily. Fragmin was administered as a daily subcutaneous injection of 200 units kg À1 for the first 28 days and 5000 units thereafter. Marimastat was given at 10 mg bd orally. Serum, plasma and urinary angiogenic factors were measured at baseline and after 1 month of treatment. Inhibition of release of tumour necrosis factor alpha (TNF-alpha) from peripheral lymphocytes was used as a surrogate pharmacodynamic end point. There was one case of haemorrhagic stroke and one upper gastrointestinal haemorrhage. The commonest toxicity was myalgia. One of 10 patients with renal cancer had a partial response, and three patients had a prolonged period of stable disease. The treatment significantly inhibited phytohaemagglutinin (PHA)-stimulated TNF-alpha release from patient's lymphocytes. The combination of marimastat, fragmin and captopril is well tolerated and has in vivo activity. Inhibition of PHA-stimulated TNF-alpha release from lymphocytes is a surrogate pharmacodynamic marker of metalloprotease inhibition.

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“…have a higher risk of developing incident VTE compared to matched non-cancer patients [15,16], they have a higher risk of recurrent VTE [17,18], and development of VTE in cancer patients is associated with higher mortality [19][20][21]. The management of acute VTE in cancer patients is challenging because they have an increased risk of developing major bleeding during anticoagulation therapy [17].…”

Section: Cancer and Thrombosis Inferior Vena Cava Filter Venous Thrommentioning

confidence: 99%

“…The management of acute VTE in cancer patients is challenging because they have an increased risk of developing major bleeding during anticoagulation therapy [17]. The use of IVCFs has emerged as a particularly common therapeutic modality in patients with cancer in the United States although the clinical benefit in this setting is also controversial [22,23].…”

Section: Cancer and Thrombosis Inferior Vena Cava Filter Venous Thrommentioning

confidence: 99%

Inferior vena cava filters in patients with cancer and venous thromboembolism (VTE): patterns of use and outcomes

Brunson¹,

Ho²,

White

et al. 2016

Thrombosis Research

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Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis

Cited by 1,654 publications

References 32 publications

Edoxaban Exposure‐Response Analysis and Clinical Utility Index Assessment in Patients With Symptomatic Deep‐Vein Thrombosis or Pulmonary Embolism

Edoxaban Exposure‐Response Analysis and Clinical Utility Index Assessment in Patients With Symptomatic Deep‐Vein Thrombosis or Pulmonary Embolism

Combination antiangiogenesis therapy with marimastat, captopril and fragmin in patients with advanced cancer

Inferior vena cava filters in patients with cancer and venous thromboembolism (VTE): patterns of use and outcomes

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