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. 2019;5(3):67-71.
doi: 10.20407/fmj.2018-012. Epub 2019 Apr 17.

Preliminary therapeutic outcomes of using direct oral anticoagulants to treat venous thromboembolism in gynecological cancer patients

Sayaka Osaki  1 , Satoshi Kawai  1 , Mayuko Ito  1 , Sayaka Otani  1 , Ryoko Ichikawa  1 , Yutaka Torii  1 , Hiroshi Takahashi  2 , Hiroshi Toyama  3 , Yukio Ozaki  4 , Takuma Fujii  1
Affiliations

Preliminary therapeutic outcomes of using direct oral anticoagulants to treat venous thromboembolism in gynecological cancer patients

Sayaka Osaki et al. Fujita Med J. 2019.

Abstract

Objectives: Venous thromboembolism (VTE) is often a problematic complication in patients with gynecological cancer. Despite increasing opportunities to use direct oral anticoagulants (DOACs) to treat VTE, there are no reports on the therapeutic outcomes of DOACs in patients with gynecological cancer; however, there are some studies on cancer patients in general. We retrospectively examined the efficacy and safety of using DOACs to treat VTE in such patients.

Methods: The study cohort comprised 43 patients with gynecological cancer and VTE who received treatment between May 2005 and April 2016. They were divided into two groups: DOACs used (DOAC group, n=21) and only unfractionated heparin (UFH) and warfarin used (standard group, n=22). The rates of improvement and recurrence of VTE and incidence of adverse events were compared between these groups.

Results: At 6 months, the VTE of 85% of patients in the DOAC group and of 75% in the standard group had improved (p=0.59). No recurrences of VTE occurred in the DOAC group; where VTE recurred in 12.5% of patients in the standard group. Adverse events occurred in three patients in the DOAC group (15.3%) and one in the standard group (7.7%). Chemotherapy significantly impacted improvement in VTE (p=0.01).

Conclusions: Rates of VTE improvement and of recurrence of VTE and adverse events did not differ significantly between the study groups.

Keywords: Direct oral anticoagulants; Gynecological cancer; Venous thromboembolism.

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Figures

Figure 1
Figure 1
Characteristics of the 43 study patients The DOAC group included 21 patients and the standard group 22s. Nine of the 21 patients in the DOAC group received UFH and/or warfarin.
Figure 2
Figure 2
Rates of improvement by Kaplan–Meier analysis The X-axis indicates the observation period (days) and y-axis the rate of improvement. The rates of improvement in the 6 months after starting treatment were 76.4% in the DOAC group and 53.6% in the standard group; this difference this is not significant (log-rank test) (p=0.59).
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