Publication:
Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study.

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Date

2022-04-20

Authors

Trujillo-Santos, Javier
Farge-Bancel, Dominique
Pedrajas, Jose Maria
Gomez-Cuervo, Covadonga
Ballaz, Aitor
Braester, Andrei
Mahe, Isabelle
Villalobos, Aurora
Porras, Jose Antonio
Monreal, Manuel

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Wiley-Blackwell Publishing
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Abstract

Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a leading cause of morbidity and death. The objective of the RIETECAT study was to compare the long-term effectiveness and safety of enoxaparin versus dalteparin or tinzaparin for the secondary prevention of VTE in adults with active cancer. We used the data from the multicenter, multinational RIETE registry to compare the rates of VTE recurrences, major bleeding, or death over 6 months in patients with active cancer and acute VTE using full doses of enoxaparin versus dalteparin or tinzaparin, and a multivariable Cox proportional hazard model was used to analyze the primary end point. From January 2009 to June 2018, 4451 patients with active cancer received full doses of the study drugs: enoxaparin, 3526 patients; and dalteparin or tinzaparin, 925 (754 + 171) patients. There was limited difference in VTE recurrences (2.0% vs 2.5%) and mortality rate (19% vs 17%) between the enoxaparin and dalteparin or tinzaparin subgroups. However, there was a slight numerical increase in major bleeding (3.1% vs 1.9%). Propensity score matching confirmed that there were no differences in the risk for VTE recurrences (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.48-1.38), major bleeding (aHR, 1.40; 95% CI, 0.80-2.46), or death (aHR, 1.07; 95% CI, 0.88-1.30) between subgroups. In RIETECAT, in patients with cancer and VTE receiving full-dose enoxaparin or dalteparin or tinzaparin, no statistically significant differences were observed regarding effectiveness and safety outcomes over a 6-month period.

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Proportional Hazards Models
Propensity Score
Secondary Prevention
Hemorrhage

DeCS Terms

Enoxaparina
Neoplasias
Hemorragia
Modelos de riesgos proporcionales
Preparaciones farmacéuticas
Tromboembolia venosa

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Keywords

LMWH, Cancer, Cohort, Dalteparin, Enoxaparin, Recurrences, Tinzaparin, Venous thromboembolism

Citation

Trujillo-Santos J, Farge-Bancel D, Pedrajas JM, Gómez-Cuervo C, Ballaz A, Braester A, et al. Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study. Res Pract Thromb Haemost. 2022 Jun 3;6(4):e12736