NEJM:阿哌沙班治疗癌症相关的静脉血栓栓塞疗效

2020-04-23 MedSci原创 MedSci原创

最近的指南建议考虑使用口服依度沙班或利伐沙班治疗癌症患者的静脉血栓栓塞。然而,这些口服制剂的益处受到与增加的出血风险的限制。

最近的指南建议考虑使用口服依度沙班或利伐沙班治疗癌症患者的静脉血栓栓塞。然而,这些口服制剂的益处受到与增加的出血风险的限制。此前报道:NEJM:阿哌沙班在治疗癌症相关VTE方面不逊于达肝素(Caravaggio研究)

此前相关报道:NEJM:阿哌沙班预防癌症患者的静脉血栓栓塞

近日,顶级医学期刊NEJM上发表了一篇研究文章,在这项多国性、随机、研究者发起的、开放性、非劣效性试验中,研究人员将有症状或突发急性近端深静脉血栓形成或肺栓塞的癌症患者随机分配为接受口服阿哌沙班(前7天每天两次,每次10mg,然后每天两次,每次5mg)或皮下达肝素(第一个月每天一次,剂量为200 IU/kg体重,随后每天一次,剂量为150 IU/kg体重),治疗6个月。该研究的主要结局是在试验期间客观确认的复发性静脉血栓栓塞。主要安全结局是大出血。

阿哌沙班组576例患者中有32例(5.6%)发生复发性静脉血栓栓塞,达肝素组579例患者中有46例(7.9%)发生复发性静脉血栓栓塞(风险比为0.63; 95%置信区间[CI]为0.37至1.07;P<0.001(非劣效性)。在阿哌沙班组中有22例患者(3.8%)发生了大出血,在达肝素组中有23例患者(4.0%)发生了大出血(风险比为0.82; 95%CI为0.40至1.69;P=0.60)。

由此可见,口服阿哌沙班在治疗癌症相关的静脉血栓栓塞方面不逊于皮下达肝素,而不会增加大出血的风险。

原始出处:

Giancarlo Agnelli.et al.Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer.NEJM.2020.https://www.nejm.org/doi/full/10.1056/NEJMoa1915103

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    2020-05-05 xue8602
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    2020-11-02 lovetcm

    #阿哌沙班#治疗#癌症#相关的静脉#血栓栓塞#疗效,不仅如此,说不定还能提高疗效

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1953182, encodeId=bfef195318223, content=<a href='/topic/show?id=d441e1440e8' target=_blank style='color:#2F92EE;'>#癌症相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71440, encryptionId=d441e1440e8, topicName=癌症相关)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Mar 09 02:21:32 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955483, encodeId=a0f31955483d1, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue May 05 16:21:32 CST 2020, time=2020-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2019710, encodeId=18992019e1078, content=<a href='/topic/show?id=1c1ce1449e6' target=_blank style='color:#2F92EE;'>#癌症相关的静脉血栓栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71449, encryptionId=1c1ce1449e6, topicName=癌症相关的静脉血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Fri Feb 19 06:21:32 CST 2021, time=2021-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896294, encodeId=9fc689629486, content=<a href='/topic/show?id=95089e7452f' target=_blank style='color:#2F92EE;'>#阿哌沙班#</a>治疗<a href='/topic/show?id=d8dbe130197' target=_blank style='color:#2F92EE;'>#癌症#</a>相关的静脉<a href='/topic/show?id=23c58911686' target=_blank style='color:#2F92EE;'>#血栓栓塞#</a>疗效,不仅如此,说不定还能提高疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97745, encryptionId=95089e7452f, topicName=阿哌沙班), TopicDto(id=71301, encryptionId=d8dbe130197, topicName=癌症), TopicDto(id=89116, encryptionId=23c58911686, topicName=血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Nov 02 16:39:55 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698080, encodeId=492916980808d, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Dec 05 23:21:32 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032485, encodeId=5bfe1032485b1, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu Apr 23 11:21:32 CST 2020, time=2020-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035244, encodeId=7ac9103524421, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 23 11:21:32 CST 2020, time=2020-04-23, status=1, ipAttribution=)]
    2020-12-05 fusion
  6. [GetPortalCommentsPageByObjectIdResponse(id=1953182, encodeId=bfef195318223, content=<a href='/topic/show?id=d441e1440e8' target=_blank style='color:#2F92EE;'>#癌症相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71440, encryptionId=d441e1440e8, topicName=癌症相关)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Mar 09 02:21:32 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955483, encodeId=a0f31955483d1, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue May 05 16:21:32 CST 2020, time=2020-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2019710, encodeId=18992019e1078, content=<a href='/topic/show?id=1c1ce1449e6' target=_blank style='color:#2F92EE;'>#癌症相关的静脉血栓栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71449, encryptionId=1c1ce1449e6, topicName=癌症相关的静脉血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Fri Feb 19 06:21:32 CST 2021, time=2021-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896294, encodeId=9fc689629486, content=<a href='/topic/show?id=95089e7452f' target=_blank style='color:#2F92EE;'>#阿哌沙班#</a>治疗<a href='/topic/show?id=d8dbe130197' target=_blank style='color:#2F92EE;'>#癌症#</a>相关的静脉<a href='/topic/show?id=23c58911686' target=_blank style='color:#2F92EE;'>#血栓栓塞#</a>疗效,不仅如此,说不定还能提高疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97745, encryptionId=95089e7452f, topicName=阿哌沙班), TopicDto(id=71301, encryptionId=d8dbe130197, topicName=癌症), TopicDto(id=89116, encryptionId=23c58911686, topicName=血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Nov 02 16:39:55 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698080, encodeId=492916980808d, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Dec 05 23:21:32 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032485, encodeId=5bfe1032485b1, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu Apr 23 11:21:32 CST 2020, time=2020-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035244, encodeId=7ac9103524421, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 23 11:21:32 CST 2020, time=2020-04-23, status=1, ipAttribution=)]
    2020-04-23 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1953182, encodeId=bfef195318223, content=<a href='/topic/show?id=d441e1440e8' target=_blank style='color:#2F92EE;'>#癌症相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71440, encryptionId=d441e1440e8, topicName=癌症相关)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Mar 09 02:21:32 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955483, encodeId=a0f31955483d1, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue May 05 16:21:32 CST 2020, time=2020-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2019710, encodeId=18992019e1078, content=<a href='/topic/show?id=1c1ce1449e6' target=_blank style='color:#2F92EE;'>#癌症相关的静脉血栓栓塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71449, encryptionId=1c1ce1449e6, topicName=癌症相关的静脉血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Fri Feb 19 06:21:32 CST 2021, time=2021-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=896294, encodeId=9fc689629486, content=<a href='/topic/show?id=95089e7452f' target=_blank style='color:#2F92EE;'>#阿哌沙班#</a>治疗<a href='/topic/show?id=d8dbe130197' target=_blank style='color:#2F92EE;'>#癌症#</a>相关的静脉<a href='/topic/show?id=23c58911686' target=_blank style='color:#2F92EE;'>#血栓栓塞#</a>疗效,不仅如此,说不定还能提高疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97745, encryptionId=95089e7452f, topicName=阿哌沙班), TopicDto(id=71301, encryptionId=d8dbe130197, topicName=癌症), TopicDto(id=89116, encryptionId=23c58911686, topicName=血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Nov 02 16:39:55 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698080, encodeId=492916980808d, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Dec 05 23:21:32 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032485, encodeId=5bfe1032485b1, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Thu Apr 23 11:21:32 CST 2020, time=2020-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035244, encodeId=7ac9103524421, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 23 11:21:32 CST 2020, time=2020-04-23, status=1, ipAttribution=)]
    2020-04-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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