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https://www.readbyqxmd.com/read/29231094/edoxaban-for-the-treatment-of-cancer-associated-venous-thromboembolism
#1
Gary E Raskob, Nick van Es, Peter Verhamme, Marc Carrier, Marcello Di Nisio, David Garcia, Michael A Grosso, Ajay K Kakkar, Michael J Kovacs, Michele F Mercuri, Guy Meyer, Annelise Segers, Minggao Shi, Tzu-Fei Wang, Erik Yeo, George Zhang, Jeffrey I Zwicker, Jeffrey I Weitz, Harry R Büller
Background Low-molecular-weight heparin is the standard treatment for cancer-associated venous thromboembolism. The role of treatment with direct oral anticoagulant agents is unclear. Methods In this open-label, noninferiority trial, we randomly assigned patients with cancer who had acute symptomatic or incidental venous thromboembolism to receive either low-molecular-weight heparin for at least 5 days followed by oral edoxaban at a dose of 60 mg once daily (edoxaban group) or subcutaneous dalteparin at a dose of 200 IU per kilogram of body weight once daily for 1 month followed by dalteparin at a dose of 150 IU per kilogram once daily (dalteparin group)...
December 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29223438/-bringing-on-the-light-in-a-complex-clinical-scenario-optical-coherence-tomography-guided-discontinuation-of-antiplatelet-therapy-in-cancer-patients-with-coronary-artery-disease-protect-oct-registry
#2
Cezar A Iliescu, Mehmet Cilingiroglu, Dana E Giza, Oscar Rosales, Jake Lebeau, Israel Guerrero-Mantilla, Juan Lopez-Mattei, Juhee Song, Guillherme Silva, Pranav Loyalka, Andre R M Paixao, Syed Wamique Yusuf, Emerson Perin, Vernon H Anderson, Konstantinos Marmagkiolis
BACKGROUND: Cancer patients with recently placed drug-eluting stents (DESs) often require premature dual antiplatelet therapy (DAPT) discontinuation for cancer-related procedures. Optical coherence tomography (OCT) can identify risk factors for stent thrombosis such as stent malapposition, incomplete strut coverage and in-stent restenosis and may help guide discontinuation of DAPT. METHODS: We conducted a single-center prospective study in cancer patients with recently placed (1-12 months) DES who required premature DAPT discontinuation...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222246/incidental-venous-thromboembolism-is-anticoagulation-indicated
#3
REVIEW
Marcello Di Nisio, Marc Carrier
Patients with cancer have a high risk of venous thromboembolism (VTE) and about one-half of these events are incidentally detected. The prognosis of incidental VTE appears to be similar to symptomatic events, with comparably high rates of recurrent VTE in this patient population. In the absence of major contraindications, anticoagulant treatment with low-molecular-weight heparin for 3 to 6 months is generally recommended for incidental proximal deep vein thrombosis as well as for incidental pulmonary embolism that involves multiple subsegmental or more proximal pulmonary arteries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29202544/-the-460th-case-lower-extremity-edema-positive-fecal-occult-blood
#4
Y D Sun, J L Zhao, P Zhang, Q Wang, M T Li
An 61-year-old woman presenting deep vein thrombosis and persistent positive anticardiolipin antibodies was diagnosed as antiphospholipid syndrome and treated with low molecular weight heparin. Before and after anticoagulant therapy, continuous positive fecal occult-blood was found asymptomatically. Colonoscopy confirmed rectal cancer. Antiphospholipid autoantibodies are non-specially positive in some malignances, especially in elder onset patients. Thus, routine screening of malignancies is strongly suggested...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29202214/vitamin-k-antagonists-compared-to-low-molecular-weight-heparins-for-treatment-of-cancer-associated-venous-thromboembolism-an-observational-study-in-routine-clinical-practice
#5
Paul L den Exter, José Hooijer, Tom van der Hulle, Julien P van Oosten, Olaf M Dekkers, Frederikus A Klok, Menno V Huisman
Since several trials have demonstrated that low-molecular-weight-heparin (LMWH) is superior to vitamin K antagonist (VKA) in preventing recurrent venous thromboembolism (VTE) in patients with cancer-associated VTE, guidelines now recommend LMWH monotherapy in this setting. We evaluated whether this shift resulted in improved outcomes in routine clinical practice. We performed a cohort study of consecutive patients with cancer-associated VTE during 2001 and 2010. We compared the risks for recurrent VTE, major bleeding and mortality between patients diagnosed before and after 2008 during a 6-month routine follow-up...
November 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29188376/the-role-of-direct-oral-anticoagulants-in-cancer-related-venous-thromboembolism-a-perspective-beyond-the-guidelines
#6
REVIEW
Cristhiam M Rojas-Hernandez
Cancer-related venous thromboembolism (Wickham et al., Intern Med J 42(6):698-708, 2012) is an important source of morbidity and mortality in that population. The standard of care for the treatment of cancer-related venous thromboembolism (VTE) is a low molecular weight heparin (LMWH) for long periods of time. The favorable clinical trial results for efficacy and safety and availability of direct oral anticoagulants (DOAC) have remodeled the care and options for treatment of venous thromboembolism in the adult population...
November 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29175954/cd44-signaling-mediates-high-molecular-weight-hyaluronan-induced-anti-hyperalgesia
#7
Luiz F Ferrari, Eugen V Khomula, Dioneia Araldi, Jon D Levine
We studied, in male Sprague-Dawley rats, the role of the cognate hyaluronan (HA) receptor, CD44 signaling in the anti-hyperalgesia induced by high molecular weight hyaluronan (HMWH). Low molecular weight hyaluronan (LMWH) acts at both peptidergic and non-peptidergic nociceptors to induce mechanical hyperalgesia that is prevented by intrathecal oligodeoxynucleotide (ODN) antisense to CD44 mRNA, which also prevents hyperalgesia induced by a CD44 receptor agonist, A6. Ongoing LMWH and A6 hyperalgesia is reversed by HMWH...
November 23, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29158366/therapeutic-anticoagulation-in-patients-with-primary-brain-tumors-or-secondary-brain-metastasis
#8
REVIEW
Richard J Lin, David L Green, Gunjan L Shah
Patients with primary or metastatic brain tumors are at increased risk of developing venous thromboses. However, the potential benefit of therapeutic anticoagulation in these patients must be weighed against the deadly complication of intracranial hemorrhage. In this review, we summarize available evidence and recent studies of intracranial bleeding risks in primary and metastatic tumors and the impact of therapeutic anticoagulation. We find that for the majority of primary and treated metastatic brain tumors, the risk of spontaneous bleeding is acceptable and not further increased by careful therapeutic anticoagulation with low molecular weight heparin or direct oral anticoagulants, although thrombocytopenia (platelet count less than 50,000/μL) and other coagulopathies are relative contraindications...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29157146/evaluation-of-rivaroxaban-use-in-patients-with-gynecologic-malignancies-at-an-academic-medical-center-a-pilot-study
#9
Jessie R Signorelli, Arpita S Gandhi
Background Patients with gynecologic malignancies are at an increased risk for venous thromboembolism. National guidelines recommend treatment of an acute venous thromboembolism with low molecular weight heparin for 5-10 days followed by long-term secondary prophylaxis with low molecular weight heparin for at least six months. Non-vitamin K oral anticoagulants are not currently recommended to be used in cancer patients for the management of venous thromboembolism because robust data on their efficacy and safety have yet to become available in cancer patients...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29106448/randomized-phase-iii-trial-of-low-molecular-weight-heparin-enoxaparin-in-addition-to-standard-treatment-in-small-cell-lung-cancer-the-rasten-trial
#10
L Ek, E Gezelius, B Bergman, P O Bendahl, H Anderson, J Sundberg, M Wallberg, U Falkmer, S Verma, M Belting
Background: Coagulation activation and venous thromboembolism (VTE) are hallmarks of malignant disease and represent a major cause of morbidity and mortality in cancer. Coagulation inhibition with low molecular weight heparin (LMWH) may improve survival specifically in small cell lung cancer (SCLC) patients by preventing VTE and tumor progression; however, randomized trials with well-defined patient populations are needed to obtain conclusive data. The aim of RASTEN was to investigate the survival effect of LMWH enoxaparin in a homogenous population of SCLC patients...
November 2, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29088922/the-role-of-tinzaparin-in-oncology
#11
Evangelos P Dimakakos, Ioannis Vathiotis, Konstantinos Syrigos
Current guidelines recommend low-molecular-weight heparin treatment in patients with cancer with established venous thromboembolism (VTE). The aim of this article was to study the pharmacological properties and effectiveness of tinzaparin in patients with cancer as well as its potential anticancer properties. A search of PubMed and ScienceDirect databases up to March 2016 was carried out to identify published studies that detect the properties and use of tinzaparin in oncology. Protamine sulfate partially (60% to 65%) neutralized tinzaparin's anti-Xa activity...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29068809/advances-in-managing-and-preventing-thromboembolic-disease-in-cancer-patients
#12
Anthony Maraveyas, Iqtedar Muazzam, Simon Noble, George Bozas
PURPOSE OF REVIEW: To update on new data for low-molecular weight heparins (LMWHs) and the direct oral anticoagulants (DOACs) for the treatment and prevention of cancer-associated thrombosis (CAT), to discuss progress with the risk-adaptive management scores (RAMS) and update on increased dose primary thromboprophylaxis (IDPTP). RECENT FINDINGS: In a pooled meta-analysis of 1132 cancer patients who received DOACs vs. vitamin K analogues (VKAs), recurrence of venous thromboembolism (VTE) was reduced from 6...
December 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29052104/anticoagulation-prescribing-patterns-in-patients-with-cancer
#13
Elaine Xiang, Tania Ahuja, Veronica Raco, Frank Cirrone, David Green, John Papadopoulos
Cancer is a known hypercoagulable state that leads to an increased risk of venous thromboembolism (VTE). Low molecular weight heparin remains the preferred anticoagulant for VTE in patients with cancer over vitamin K antagonist. However, the preferred anticoagulant in prevention of stroke and systemic embolism in atrial fibrillation (AF) in patients with cancer has yet to be determined. The direct oral anticoagulants (DOACs) are increasingly being utilized; however their role in cancer has only recently been investigated...
October 19, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28981552/vitamin-k-antagonists-compared-to-low-molecular-weight-heparins-for-treatment-of-cancer-associated-venous-thromboembolism-an-observational-study-in-routine-clinical-practice-an-observational-study-in-routine-clinical-practice
#14
Paul L den Exter, José Hooijer, Tom van der Hulle, Julien P van Oosten, Olaf M Dekkers, Frederikus A Klok, Menno V Huisman
Since several trials have demonstrated that low-molecular-weight-heparin (LMWH) is superior to vitamin K antagonist (VKA) in preventing recurrent venous thromboembolism (VTE) in patients with cancer-associated VTE, guidelines now recommend LMWH monotherapy in this setting. We evaluated whether this shift resulted in improved outcomes in routine clinical practice. We performed a cohort study of consecutive patients with cancer-associated VTE during 2001 and 2010. We compared the risks for recurrent VTE, major bleeding and mortality between patients diagnosed before and after 2008 during a 6-month routine follow-up...
October 4, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28980383/incidence-of-venous-thromboembolic-events-in-enhanced-recovery-after-surgery-for-colon-cancer-a-retrospective-population-based-cohort-study
#15
Momo M I Vendler, Tamim A Haidari, Jo E Waage, Jakob Kleif, Bent Kristensen, Ismail Gögenur, Claus A Bertelsen
AIM: Both the Danish and NICE guidelines recommend prolonged thromboprophylaxis (PT) with low-molecular-weight heparin (LMWH) for 28 days postoperatively after elective surgery for colon cancer. The evidence relies on two RCTs that included not only colon cancers but also other abdominal cancers or benign colorectal diseases. Neither of those studies investigated the risk of venous thromboembolism (VTE) under Enhanced Recovery After Surgery (ERAS). We aim to describe the risk of VTE and estimate the cost of preventing one case of VTE by PT under ERAS...
October 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28978053/heparin-antagonizes-cisplatin-resistance-of-a2780-ovarian-cancer-cells-by-affecting-the-wnt-signaling-pathway
#16
Daniel Bastian Pfankuchen, Fabian Baltes, Tahira Batool, Jin-Ping Li, Martin Schlesinger, Gerd Bendas
Low molecular weight heparin (LMWH), the guideline based drug for prophylaxis and treatment of cancer-associated thrombosis, was recently shown to sensitize cisplatin resistant A2780cis human ovarian cancer cells for cisplatin cytotoxicity upon 24 h pretreatment with 50 μg × mL(-1) of the LMWH tinzaparin in vitro, equivalent to a therapeutic dosage. Thereby, LMWH induced sensitization by transcriptional reprogramming of A2780cis cells via not yet elucidated mechanisms that depend on cellular proteoglycans...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28964384/prevention-and-treatment-of-cancer-associated-thrombosis-in-france-a-national-survey-among-vascular-disease-and-supportive-care-specialists
#17
I Mahé, F Scotté, J-B Rey, I Elalamy, A Lamblin, D Mayeur, G Pernod
BACKGROUND/AIM: Long-term use of low-molecular-weight heparins (LMWH) for the treatment of cancer-associated thrombosis (CAT) has been well-established. Conversely, the use of thromboprophylaxis in patients with cancer remains controversial in the absence of homogeneous guidelines. Our aim was to assess the awareness of treatment guidelines and the management of patients with CAT in daily clinical practice. METHODS: A national survey based on an open questionnaire developed by a panel of health professionals including specialists in vascular medicine, oncology, supportive care and pharmacy, was proposed on line to 2104 specialists experts in the management of CAT with the objective to collect at least 400 answers...
October 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/28949077/primary-thromboprophylaxis-ptp-in-ambulatory-patients-with-lung-cancer-receiving-chemotherapy-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-rcts
#18
Kyaw Zin Thein, Sai-Ching J Yeung, Thein Hlaing Oo
BACKGROUND: Thromboembolism (TE) is a leading cause of death in cancer patients. Primary thromboprophylaxis (PTP) in ambulatory cancer patients receiving chemotherapy has been debated and considered to potentially improve survival by reducing TE occurrence. OBJECTIVE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) in ambulatory lung cancer (LC) patients on chemotherapy to determine the benefit and risk of PTP with low-molecular-weight heparins (LMWHs)...
September 26, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28947885/the-safety-of-low-molecular-weight-heparins-in-the-prevention-of-venous-thromboembolism-in-surgically-treated-cancer-patients-results-of-a-multicentre-observational-study
#19
Tomasz Olesiński, Anna Fijałkowska, Andrzej Rutkowski
AIM OF THE STUDY: Despite widespread use of pharmacological prophylaxis, venous thromboembolism (VTE) still constitutes a common complication in cancer patients. The aim of the study was to analyse the safety of low-molecular-weight heparins (LMWH) in the prevention of VTE in surgically-treated cancer patients. MATERIAL AND METHODS: A total of 5207 cancer patients (44.5% men and 55.5% women) aged 16-97 years participated in a prospective observational study conducted in 13 Polish cancer centres in 2005-2008...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/28942721/assessment-of-venous-thromboembolism-treatment-in-patients-with-cancer-on-low-molecular-weight-heparin-warfarin-and-the-direct-oral-anticoagulants
#20
Ellen M Uppuluri, Kelly R Burke, Christina Mactal Haaf, Nancy L Shapiro
Background Direct oral anticoagulants (DOACs) are not recommended for venous thromboembolism (VTE) treatment in patients with cancer because their safety and efficacy have not been compared to low molecular weight heparin (LMWH) in large trials. Routine anti-Xa monitoring in cancer patients on LMWH is also not recommended due to limited data correlating anti-Xa levels and outcomes. Objective Compare the safety and efficacy of DOACs to LMWH and warfarin and assess the relationship of anti-Xa monitoring and outcomes in patients with cancer taking LMWH in an urban university setting...
January 1, 2017: Journal of Oncology Pharmacy Practice
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