(HealthDay News) — Rivaroxaban can prevent venous thromboembolism (VTE) in cancer patients at increased risk, according to a study presented at the annual meeting of the American Society of Hematology, held from Dec. 1 to 4 in San Diego.

Alok A. Khorana, MD, from the Cleveland Clinic, and colleagues conducted a double-blind, randomized, multicenter study involving adult ambulatory patients with cancer who were initiating a new systemic regimen and were at increased risk for VTE. Participants were screened for deep-vein thrombosis (DVT) and were randomly assigned to rivaroxaban or placebo if no DVT was found. A total of 841 patients were randomized.

The researchers found that the primary efficacy end point (composite of asymptomatic or symptomatic lower-extremity proximal DVT, symptomatic upper- or lower-extremity distal DVT, symptomatic or incidental pulmonary embolism, and VTE-related death) occurred in 5.95 and 8.79% of patients in the rivaroxaban and placebo groups, respectively (hazard ratio, 0.66; 95% confidence interval, 0.40 to 1.09; P=0.101) in the up-to-180-day observation period. Overall, 38.7% of patients with VTE experienced events after discontinuing the study drug. The primary end point occurred in 2.62 and 6.41% of patients in the rivaroxaban and placebo groups, respectively (hazard ratio, 0.40; 95% confidence interval, 0.20 to 0.80; P=0.007) in a prespecified analysis of all randomly assigned patients during the on-treatment period.

“This signals a change in the prevention approaches to cancer-associated VTE,” Khorana said in a statement. “We are moving into a new era of direct oral anticoagulants.”

One author disclosed financial ties to pharmaceutical companies, including Bayer, which funded the study with Janssen, the manufacturer of rivaroxaban.

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Khorana AA, Soff GA, Kakkar AK, et al. LBA-1 Rivaroxaban Thromboprophylaxis in High-Risk Ambulatory Cancer Patients Receiving Systemic Therapy: Results of a Randomized Clinical Trial (CASSINI). ASH 2018. Late-breaking abstract (Published online December 4, 2018)

Oral Anticoagulants Show Benefit for Cancer Patients at High-Risk of Venous Thromboembolism. Cleveland Clinic; December 4, 2018 (Press Release)