直接口服抗凝剂用于与癌症相关的静脉血栓栓塞
Marta Masini1, Matteo Toma2, Paolo Spallarossa2
1Department of Internal Medicine, University of Genova, Viale Benedetto XV, 6 - 16132, Genoa, Italy.
Current oncology reports
|June 6, 2023
概括
直接口服抗凝剂 (DOAC) 是有效的治疗和预防癌症相关的静脉血栓栓塞 (CAT),但增加胃肠道出血的风险. 对于特定的患者群体需要进行进一步的研究.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 与癌症相关的静脉血栓栓塞 (CAT) 是一个常见的并发症.
- 低分子量肝素 (LMWH) 是标准的治疗方法.
- 直接口服抗凝剂 (DOAC) 是一种具有潜在益处的替代品.
研究的目的:
- 审查对CAT的DOAC随机对照试验 (RCT) 证据.
- 为了确定DOAC使用的不确定性和特定的患者子组.
主要方法:
- 对对比DOAC与LMWH用于CAT治疗和预防的RCT的系统审查.
- 分析有效性和安全性数据,包括出血风险.
主要成果:
- 在CAT治疗中,DOACs (rivaroxaban,edoxaban,apixaban) 与LMWH没有劣势.
- 在患有胃肠道癌症的患者中,DOAC增加了主要胃肠道出血的风险.
- 在高风险化疗患者中,DOACs可以预防CAT,但会增加出血.
- 对于内瘤或血小板狭窄症患者的数据有限.
结论:
- 目前的指导方针建议DOAC用于CAT治疗和选择性预防.
- 在特定的患者亚组中,需要仔细考虑DOACs与LMWH.
- 需要进一步的研究来确定在复杂情况下最佳的DOAC使用.
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