RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Purpose: Although direct oral anticoagulants (DOACs) are recommended as an alternative to low-molecular weighted heparin for cancer-associated venous thromboembolism (VTE), there is no firm evidence on the efficacy and safety of DOACs in patients with urologic cancer. Therefore, we compared the efficacy and safety of rivaroxaban and dalteparin for treating cancer-associated VTE in urologic cancer.
Materials and Methods: We reviewed the medical records of 124 eligible VTE patients with urologic cancers who were treated with dalteparin or rivaroxaban. The primary outcome was the composite event of clinically relevant bleeding or VTE recurrence. The secondary outcomes were VTE recurrence, clinically relevant bleeding events, and all-cause mortality.
Results: During anticoagulation period, there was no significant difference in primary and secondary outcomes between the groups. In Cox proportional hazards model for composite events, although there was no statistical significance, rivaroxaban presented lower hazard ratio (HR) than dalteparin (HR, 0.472; 95% confidence interval [CI], 0.210–1.060; p=0.069 in univariate analysis; HR, 0.505; 95% CI, 0.206–1.234; p=0.134 in multivariate analysis). In clinically relevant bleeding events, there was no significance difference between rivaroxaban and dalteparin (HR, 0.568; 95% CI, 0.238–1.358; p=0.203 in univariate analysis; HR, 0.617; 95% CI, 0.232–1.636; p=0.331 in multivariate analysis).
Conclusions: Rivaroxaban can be regarded as a valuable option for VTE in urologic cancer. Further prospective studies are warranted to prove the safety or efficacy of rivaroxaban for treating VTE in patients with urologic cancer.

번역하기

참고문헌 (Reference)

1 Vedovati MC, "Venous thromboembolism and cancer: Current and future role of direct- acting oral anticoagulants" 177 : 33-41, 2019

2 Zareba P, "Thromboembolism in Patients with Bladder Cancer: Incidence, Risk Factors and Prevention" 4 : 139-147, 2018

3 Brodie MM, "Severity of Gastrointestinal Bleeding in Patients Treated with Direct-Acting Oral Anticoagulants" 131 : 573.e9-573.e15, 2018

4 Khorana AA, "Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from the SSC of the ISTH" 16 : 1891-1894, 2018

5 이장호, "Rivaroxaban versus Low-Molecular- Weight Heparin for Venous Thromboembolism in Gastrointestinal and Pancreatobiliary Cancer" 대한의학회 34 (34): 1-13, 2019

6 EINSTEIN Investigators, "Oral rivaroxaban for symptomatic venous thromboembolism" 363 : 2499-2510, 2010

7 Short NJ, "New oral anticoagulants and the cancer patient" 19 : 82-93, 2014

8 Streiff MB, "NCCN Guidelines Insights: Cancer-Associated Venous Thromboembolic Disease, Version 2.2018" 16 : 1289-1303, 2018

9 Weinz C, "Metabolism and excretion of rivaroxaban, an oral, direct factor Xa inhibitor, in rats, dogs, and humans" 37 : 1056-1064, 2009

10 Frydman A, "Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics and metabolism in humans" 26 (26): 24-38, 1996