Journal article
Apixaban and dalteparin in active malignancy-associated venous thromboembolism: The ADAM VTE trial
Journal of thrombosis and haemostasis, Vol.18(2), pp.411-421
02/2020
DOI: 10.1111/jth.14662
PMID: 31630479
Abstract
Low-molecular-weight heparin is the guideline-endorsed treatment for cancer-associated venous thromboembolism (VTE). While apixaban is approved for the treatment of acute VTE, limited data support its use in cancer patients.
The primary outcome was major bleeding. Secondary outcomes included VTE recurrence and a composite of major plus clinically relevant non-major bleeding (CRNMB).
Patients with cancer-associated VTE were randomly assigned to receive either apixaban 10 mg twice daily for seven days followed by 5 mg twice daily for six months or subcutaneous dalteparin (200 IU/kg for one month followed by 150 IU/kg once daily).
Of 300 patients randomized, 287 were included in the primary analysis. Metastatic disease was present in 66% of subjects; 74% were receiving concurrent chemotherapy. Major bleeding occurred in 0% of 145 patients receiving apixaban, compared with 1.4% of 142 patients receiving dalteparin [P = .138; hazard ratio (HR) not estimable because of 0 bleeding event in apixaban group]. Recurrent VTE occurred in 0.7% of apixaban, compared to 6.3% of dalteparin patients [HR 0.099, 95% confidence interval [CI], 0.013-0.780, P = .0281). Major bleeding or CRNMB rates were 6% for both groups.
Oral apixaban was associated with low major bleeding and VTE recurrence rates for the treatment of VTE in cancer patients.
Details
- Title: Subtitle
- Apixaban and dalteparin in active malignancy-associated venous thromboembolism: The ADAM VTE trial
- Creators
- Robert D McBane II - Cardiovascular Department, Mayo Clinic, Rochester, MinnesotaWaldemar E Wysokinski - Mayo Clinic Rochester, MNJennifer G Le-Rademacher - Mayo ClinicTyler Zemla - Mayo ClinicAneel Ashrani - Vascular Medicine Division Gonda Vascular Center Mayo Clinic Rochester MinnesotaAlfonso Tafur - NorthShore University HealthSystemUsha Perepu - University of IowaDaniel Anderson - University of MinnesotaKrishna Gundabolu - University of Nebraska Medical CenterCharles Kuzma - FirstHealth of the CarolinasJuliana Perez Botero - Froedtert Cancer Center, Milwaukee, WisconsinRoberto A Leon Ferre - Mayo ClinicStanislav Henkin - Dartmouth–Hitchcock Medical CenterCharles J Lenz - Mayo Clinic Rochester, MNDamon E Houghton - Mayo Clinic Rochester, MNPrakash Vishnu - Mayo Clinic in FloridaCharles L Loprinzi - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Journal of thrombosis and haemostasis, Vol.18(2), pp.411-421
- DOI
- 10.1111/jth.14662
- PMID
- 31630479
- ISSN
- 1538-7933
- eISSN
- 1538-7836
- Grant note
- DOI: 10.13039/100004319, name: Pfizer
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359926602771
Metrics
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