(HealthDay News) — For patients with active cancer and venous thromboembolism (VTE), rivaroxaban is associated with lower VTE recurrence compared with dalteparin, but with elevated clinically relevant non-major bleeding (CRNMB), according to a study published online in the Journal of Clinical Oncology.
Annie M. Young, PhD, from Warwick Medical School University in the United Kingdom, and colleagues conducted a randomized trial involving patients with active cancer who had symptomatic pulmonary embolism (PE), incidental PE, or symptomatic lower-extremity proximal deep vein thrombosis. Patients were randomized to dalteparin or rivaroxaban (203 patients to each group); 58% of patients had metastases.
The researchers found that 26 patients experienced recurrent VTE (18 and 8 patients in the dalteparin and rivaroxaban groups, respectively). The 6-month cumulative VTE recurrence rate was 11 and 4% with dalteparin and rivaroxaban, respectively (hazard ratio, 0.43; 95% confidence interval, 0.19 to 0.99). The six-month cumulative rate of major bleeding was 4 and 6% for dalteparin and rivaroxaban, respectively (hazard ratio, 1.83; 95% confidence interval, 0.68 to 4.96). The corresponding rates of CRNMB were 4 and 13% (hazard ratio, 3.76; 95% confidence interval, 1.63 to 8.69).
“Rivaroxaban was associated with relatively low VTE recurrence but higher CRNMB compared with dalteparin,” the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Bayer, which provided rivaroxaban and placebo tablets.
Young AM, Marshall A, Thirlwall J, et al. Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D). J Clin Oncol. DOI: 10.1200/JCO.2018.78.8034 [Published online May 10, 2018]