荷兰癌症相关血栓的治疗模式:四个城市的研究
Fleur H J Kaptein1, Noori A M Guman2,3,4, Susan B Lohle2,3
1Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.
TH open : companion journal to thrombosis and haemostasis
|February 1, 2024
概括
直接口服抗凝剂 (DOAC) 越来越多地用于与癌症相关的静脉血栓塞栓症 (VTE). 治疗变化很常见,通常是由于复发性静脉动脉突发症或出血并发症.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床药理学 临床药理学
背景情况:
- 目前的指导方针建议低分子量肝素 (LMWH) 或直接口服抗凝剂 (DOAC) 用于与癌症相关的静脉血栓塞栓症 (VTE).
- 了解治疗趋势和结果对于优化患者护理至关重要.
研究的目的:
- 在五年 (2017-2021) 期间分析与癌症相关的VTE治疗方案.
- 为了确定初始LMWH与DOAC治疗的预测因素.
- 评估复发性VTE和重大出血 (MB) 的风险.
主要方法:
- 这是一项回顾性,多中心的队列研究,对1215名癌症相关的VTE患者进行了研究.
- 多变量逻辑回归用于识别治疗预测因素.
- 复发性VTE和MB的六个月累计发病率估计具有竞争风险.
主要成果:
- DOAC的使用量从2017年的18%大幅增加到2021年的70%.
- 性能不佳的状态和远程转移预测了LMWH的使用.
- 六个月累计发病率:复发性VTE的6.0%,MB的7.0%;经常发生调节.
结论:
- DOACs已成为癌症相关的VTE的主要治疗方法.
- 治疗方案的改变是频繁的,通常与静脉动脉突发症或出血事件有关.
- 管理与癌症相关的VTE仍然很复杂,需要仔细考虑抗凝策略.
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