@article{9eedb36071324c2f899e9affd469c6f9,
title = "Effectiveness and safety of anticoagulants for the treatment of venous thromboembolism in patients with cancer",
abstract = "Anticoagulation is used to treat venous thromboembolism (VTE) in cancer patients, but may be associated with an increased risk of bleeding. VTE recurrence and major bleeding were assessed in cancer patients treated for VTE with the most currently prescribed anticoagulants in clinical practice. Newly diagnosed cancer patients (first VTE 1/1/2013-05/31/2015) who initiated rivaroxaban, low-molecular-weight heparin (LMWH), or warfarin were identified from Humana claims data and observed until end of eligibility or end of data availability. VTE recurrence was a hospitalization with a primary diagnosis of VTE ≥7 days after first VTE. Major bleeding events on treatment were identified using validated criteria. Cohorts were compared using Kaplan–Meier rates at 6 and 12 months and Cox proportional hazards models. Cohorts were adjusted for their differences at baseline. A total of 2428 patients (rivaroxaban: 707; LMWH: 660; warfarin: 1061) met inclusion criteria. Patient characteristics were well balanced after weighting. There was a trend for lower VTE recurrence rates in rivaroxaban users compared to LMWH users at 6 months (13.2% vs. 17.1%; P =.060) and significantly lower at 12 months (16.5% vs. 22.2%; P =.030) [HR: 0.72, 95% CI: (0.52-0.95); P =.024]. VTE recurrence rates were also lower for rivaroxaban than warfarin users at 6 months (13.2% vs. 17.5%; P =.014) and 12 months (15.7% vs. 19.9%; P =.017) [HR: 0.74, 95% CI: (0.56-0.96); P =.028]. Major bleeding rates were similar across cohorts. This real-world analysis suggests cancer patients with VTE treated with rivaroxaban had significantly lower risk of recurrent VTE and similar risk of bleeding compared to those treated with LMWH or warfarin.",
author = "Streiff, {Michael B.} and Dejan Milentijevic and Keith McCrae and Daniel Yannicelli and Jonathan Fortier and Nelson, {Winnie W.} and Fran{\c c}ois Lalibert{\'e} and Concetta Crivera and Patrick Lefebvre and Jeff Schein and Khorana, {Alok A.}",
note = "Funding Information: M. B. Streiff reports having received nonfinancial support from Jans-sen (study design, statistical analysis, manuscript preparation) during the conduct of the study; outside of the submitted work, he reports having received grants and consulting fees from Janssen, consulting fees from Daiichi-Sankyo and Portola, and grants from Boehringer-Ingelheim, Portola, and Roche. C. Crivera, J. Schein, and D. Milenti-jevic are employees of Janssen Scientific Affairs, LLC, and are shareholders of Johnson & Johnson. D. Yannicelli was an employee of Janssen Pharmaceuticals, Inc. at the time of the study. W. W. Nelson was an employee of Janssen Scientific Affairs, LLC, at the time of the study and is a shareholder of Johnson & Johnson. J. Fortier, F. Lalibert{\'e}, and P. Lefebvre are employees of Analysis Group, a company that received research grants from Janssen Scientific Affairs, LLC, during the conduct of the study. A. A. Khorana has received honoraria for consulting from Janssen, Bayer, Pfizer, Halozyme, AngioDynamics, and Leo Pharma and research funding (to institution) from Amgen; A. A. Khorana would also like to acknowledge additional research support from Sondra and Stephen Hardis Endowed Chair in Oncology Research. K. McCrae has nothing to disclose. Funding Information: Technical editorial assistance was provided by Shannon O{\textquoteright}Sullivan, ELS, of MedErgy, and was supported by Janssen Scientific Affairs, LLC. Publisher Copyright: {\textcopyright} 2018 The Authors American Journal of Hematology Published by Wiley Periodicals, Inc.",
year = "2018",
month = may,
doi = "10.1002/ajh.25059",
language = "English (US)",
volume = "93",
pages = "664--671",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "5",
}