延长低剂量阿皮克萨班治疗与癌症相关的静脉血栓塞栓症.
Isabelle Mahé1,2,3,4, Marc Carrier5, Didier Mayeur6,7
1Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Louis Mourier, Service de Médecine Interne, Colombes, France.
The New England journal of medicine
|March 31, 2025
概括
用降低剂量的阿皮克萨班延长抗凝治疗有效预防癌症患者的复发性静脉血栓栓塞. 与全剂量相比,这种方法也显著降低了出血风险,提供了更安全的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉血栓栓塞 (VTE) 是活跃癌症患者的常见并发症.
- 在癌症中延长VTE治疗的最佳抗凝策略尚未明确.
- 预防复发性VTE和最大限度地降低出血风险之间的平衡至关重要.
研究的目的:
- 评估低剂量阿皮克萨班与全剂量阿皮克萨班相比在预防复发性静脉动脉瘤的非劣势.
- 评估降低剂量阿皮克萨班对临床相关出血事件的影响.
- 为了确定延长抗凝剂在患有VTE的癌症患者的安全性和有效性.
主要方法:
- 进行了一项随机,双盲,非劣等性试验.
- 1766名患有活跃癌症和VTE的患者随机分配给每天两次减少剂量 (2.5毫克) 或全剂量 (5.0毫克) 的apixaban,持续12个月.
- 主要结局:复发性VTE;关键次要结局:临床相关的出血.
主要成果:
- 降低剂量的阿皮克萨班在预防复发性静脉动脉突发症 (2.1%对2.8%) 方面与全剂量阿皮克萨班无差.
- 降低剂量的阿皮克萨班导致临床相关出血的发生率显著降低 (12.1%与15.6%相比).
- 死亡率在两组之间是相似的 (17.7%对19.6%).
结论:
- 用减少剂量的阿皮克萨班扩展抗凝药是一种安全有效的策略,用于预防活跃癌症患者的复发性静脉瘤.
- 与全剂量相比,降低剂量的阿皮克萨班提供了有利的出血特征.
- 这项研究支持在该患者群体中使用低剂量阿皮克萨班进行长期静脉瘤治疗.
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