Extended thromboprophylaxis in hospitalised patients with cancer does not reduced the rate of venous thromboembolic (VTE) events and is associated with increased risk of haemorrhage, a systematic review has found.
While the use of extended (28-42 days) thromboprophylaxis after hospitalisation has previously been shown to have benefit over standard-duration (14 days) thromboprophylaxis, this was not the case for patients with cancer, according to the review published in Blood Advances.
The systematic review and meta-analysis of the literature analysed outcomes for cancer subgroups enrolled in randomised controlled trials evaluating extended thromboprophylaxis with enoxaparin, betrixaban, or rivaroxaban.
The authors identified four RCT reporting outcomes of extended thromboprophylaxis in 3655 medically ill patients with active or history of cancer.
Patients received either extended-duration prophylaxis using enoxaparin, betrixaban, or rivaroxaban (n=1,832) or standard-duration prophylaxis using enoxaparin monotherapy (n=1,853).
The rates of VTE events were similar between the extended-duration and standard-duration groups (odds ratio [OR], 0.85).
Hospitalised patients who received extended-duration thromboprophylaxis had a higher risk of clinically relevant bleeding (OR=2.11; 95% CI 1.33-3.35).
However there was no significant risk of major bleeding (OR=1.98; 95% CI 0.62-6.35) or clinically relevant nonmajor bleeding (OR=1.85; 95% CI 0.87-3.92).