Abstract
Given the existing uncertainty regarding the effectiveness and safety of switching from low-molecular-weight heparin (LMWH) to direct oral anticoagulants (DOACs) in patients with cancer-associated venous thrombosis (CAT), we conducted a comprehensive population-based cohort study utilizing electronic health database in Hong Kong. A total of 4356 patients with CAT between 2010 and 2022 were included, with 1700 (39.0%) patients switching to DOAC treatment. Compared to continuous LMWH treatment, switching to DOACs was associated with a significantly lower risk of hospitalization due to venous thromboembolism (HR: 0.49 [95% CI = 0.35–0.68]) and all-cause mortality (HR: 0.67 [95% CI = 0.61–0.74]), with no significant difference in major bleeding (HR: 1.04 [95% CI = 0.83–1.31]) within six months. These findings provide reassurance regarding the effectiveness and safety of switching from LMWH to DOACs among patients with CAT, including vulnerable patient groups.
| Original language | English |
|---|---|
| Article number | 5657 |
| Number of pages | 11 |
| Journal | Nature Communications |
| Volume | 15 |
| Issue number | 1 |
| Early online date | 5 Jul 2024 |
| DOIs | |
| Publication status | Published - Dec 2024 |
Bibliographical note
Copyright © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/Funding
This study was supported by the Hong Kong Research Grants Council, General Research Fund (GRF), No. 17108621, which was received by E.W.C. The funding source had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data. We thank the Hong Kong Hospital Authority for access to the data from the Clinical Database Analysis and Reporting System for research purposes and the Information Technology Services, The University of Hong Kong, for offering research computing facilities for the computations in this study. We thank Lisa Y Lam, MJ, Department of Pharmacology and Pharmacy, The University of Hong Kong, for proofreading the manuscript. Ms. Lam was compensated for her contribution.