Patients with cancer are more likely than those without cancer to develop blood clots (deep vein thrombosis and pulmonary embolism), which are treated using blood thinners (anticoagulants). When clots occur, cancer patients carry a higher risk of recurring clots and more likely to bleed on blood thinning treatments. Therefore, it is critical to use blood thinners that optimize the safety and benefits. There are two main types of blood thinners that are recommended. The tablets which are direct-acting oral anticoagulants and the injections (low molecular-weight heparin). Clinical trials show the tablets may reduce clot risk but may potentially lead to more frequent bleeding, particularly in those with certain risk factors such as stomach ulcers, previous bleeding problems, certain cancer type. We aim to examine the effectiveness and safety of the tablets versus the injections for treatment of clots in cancer patients, to better understand these treatments' benefits and risks.
Study Type
OBSERVATIONAL
Enrollment
2,601
Retrospective cohort analysis using Clinical Practice Research Datalink (CPRD) GOLD and Aurum Hospital Episode Statistics (HES)-linked datasets in UK.
Retrospective cohort analysis using CPRD GOLD and Aurum HES-linked datasets in UK.
Retrospective cohort analysis using CPRD GOLD and Aurum HES-linked datasets in UK.
Many locations
Multiple Locations, United Kingdom
The risk of recurrent VTE at 3-months
Time frame: Retrospective data analysis from 2013 to 2020
Composite of any major bleeding or clinically-relevant non-major bleeding-related hospitalization at 3-months
Per the International Society on Thrombosis and Haemostasis (ISTH) criteria \[9, 10\] for identification of bleeding-associated hospitalizations.
Time frame: Retrospective data analysis from 2013 to 2020
All-cause mortality at 3-months
Time frame: Retrospective data analysis from 2013 to 2020
Recurrent VTE at 6- and 12-months post-index VTE
Time frame: Retrospective data analysis from 2013 to 2020
Composite of any major or clinically-relevant non-major bleeding-related hospitalization at 6- and 12-months post-index VTE
Including: * Intracranial hemorrhage (ICH) * Critical organ bleeding (e.g., intracranial, intraspinal, intraocular, retroperitoneal, intraarticular or pericardial bleeding or intramuscular with compartment syndrome) * Extracranial bleeding-related hospitalizations (including trauma-related)
Time frame: Retrospective data analysis from 2013 to 2020
Composite of any major bleeding or clinically-relevant non-major bleeding-related hospitalization at 6 and 12-months
Per the ISTH criteria \[9, 10\] for identification of bleeding-associated hospitalizations.
Time frame: Retrospective data analysis from 2013 to 2020
Intracranial hemorrhage (ICH), critical organ bleeding and extracranial bleeding-related hospitalizations as separate outcomes
Time frame: Retrospective data analysis from 2013 to 2020
All-cause mortality at 6- and 12-months
Time frame: Retrospective data analysis from 2013 to 2020
Incidence rates of recurrent VTE in rivaroxaban, DOAC and LMWH patients experiencing cancer-associated thrombosis (CAT) regardless of the bleeding risk associated with cancer type
Time frame: Retrospective data analysis from 2013 to 2020
Any clinically-relevant bleeding-related hospitalization in rivaroxaban, DOAC and LMWH patients experiencing cancer-associated thrombosis (CAT) regardless of the bleeding risk associated with cancer type
Time frame: Retrospective data analysis from 2013 to 2020
All cause-mortality in rivaroxaban, DOAC and LMWH patients experiencing cancer-associated thrombosis (CAT) regardless of the bleeding risk associated with cancer type
Time frame: Retrospective data analysis from 2013 to 2020
Duration of anticoagulation treatment
Time frame: Retrospective data analysis from 2013 to 2020
Discontinuation rates of rivaroxaban, DOAC and LMWH at 3-, 6-, 12-months and all available follow-up
Time frame: Retrospective data analysis from 2013 to 2020
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