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 May 10 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. 

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The researchers found that 26 patients experienced recurrent VTE (18 and eight 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 6-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.

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Several authors disclosed financial ties to pharmaceutical companies, including Bayer, which provided rivaroxaban and placebo tablets.

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