Abstract
Background: Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a leading cause of morbidity and death. Objectives: The objective of the RIETECAT study was to compare the long-term effectiveness and safety of enoxaparin versus dalteparin or tinzaparin for the secondary prevention of VTE in adults with active cancer. Methods: We used the data from the multicenter, multinational RIETE registry to compare the rates of VTE recurrences, major bleeding, or death over 6 months in patients with active cancer and acute VTE using full doses of enoxaparin versus dalteparin or tinzaparin, and a multivariable Cox proportional hazard model was used to analyze the primary end point. Results: From January 2009 to June 2018, 4451 patients with active cancer received full doses of the study drugs: enoxaparin, 3526 patients; and dalteparin or tinzaparin, 925 (754 + 171) patients. There was limited difference in VTE recurrences (2.0% vs 2.5%) and mortality rate (19% vs 17%) between the enoxaparin and dalteparin or tinzaparin subgroups. However, there was a slight numerical increase in major bleeding (3.1% vs 1.9%). Propensity score matching confirmed that there were no differences in the risk for VTE recurrences (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.48-1.38), major bleeding (aHR, 1.40; 95% CI, 0.80-2.46), or death (aHR, 1.07; 95% CI, 0.88-1.30) between subgroups. Conclusions: In RIETECAT, in patients with cancer and VTE receiving full-dose enoxaparin or dalteparin or tinzaparin, no statistically significant differences were observed regarding effectiveness and safety outcomes over a 6-month period.
| Original language | English |
|---|---|
| Article number | e12736 |
| Journal | Research and Practice in Thrombosis and Haemostasis |
| Volume | 6 |
| Issue number | 4 |
| DOIs | |
| State | Published - May 2022 |
Bibliographical note
Publisher Copyright:© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).
Funding
We express our gratitude to Sanofi Spain and LEO PHARMA for supporting this registry with an unrestricted educational grant. We also thank the RIETE Registry Coordinating Center, S&H Medical Science Service, for their quality control data, logistic, and administrative support; and Prof. Salvador Ortiz, Universidad Autónoma Madrid, and Silvia Galindo, both statistical advisors in S&H Medical Science Service, for the statistical analysis of the data presented in this paper. The manuscript was written, reviewed, and approved by the authors. Editorial support was provided by Jane Juif and Ann‐Marie Shaw from Lucid Group Communications Ltd, First Floor, Jubilee House, Third Avenue, Globe Park, Marlow, Buckinghamshire, SL7 1EY, UK, and was funded by Sanofi. We express our gratitude to Sanofi Spain and LEO PHARMA for supporting this registry with an unrestricted educational grant. We also thank the RIETE Registry Coordinating Center, S&H Medical Science Service, for their quality control data, logistic, and administrative support; and Prof. Salvador Ortiz, Universidad Autónoma Madrid, and Silvia Galindo, both statistical advisors in S&H Medical Science Service, for the statistical analysis of the data presented in this paper. The manuscript was written, reviewed, and approved by the authors. Editorial support was provided by Jane Juif and Ann-Marie Shaw from Lucid Group Communications Ltd, First Floor, Jubilee House, Third Avenue, Globe Park, Marlow, Buckinghamshire, SL7 1EY, UK, and was funded by Sanofi.
| Funders | Funder number |
|---|---|
| Lucid Group Communications Ltd | |
| S&H Medical Science Service | |
| Silvia Galindo | |
| Sanofi | |
| Universidad Autónoma de Madrid |
Keywords
- LMWH
- cancer
- cohort
- dalteparin
- enoxaparin
- recurrences
- tinzaparin
- venous thromboembolism
