ISTH Congress Abstracts

Official abstracts site for the ISTH Congress

MENU 
  • Home
  • Congress Archive
    • ISTH 2022 Congress
    • ISTH 2021 Congress
    • ISTH 2020 Congress
  • Resources
  • Search

Long-Term Management of Anticoagulants in Patients with Cancer-Associated Thrombosis (CAT) Beyond 6 Months: A 432-Patient Retrospective Non-Interventional Study

L. Plaisance1, C. Chapelle2, S. Laporte2, B. Planquette3, L. Bertoletti4, N. Falvo5, F. Coururaud6, L. Falchero7, I. Mahé8, H. Helfer9, J. Chidiac9, G. Meyer10, I. Mahé11, USCAT Group

1Université de Paris, APHP, Médecine Interne, Colombes, France, 2SAINBIOSE INSERM U 1059, Université Jean Monnet, Université de Lyon, CHU Saint-Etienne, Unité de Recherche Clinique, Innovation, Pharmacologie, Saint-Etienne, France, 3Université de Paris, APHP, Hôpital Européen Georges Pompidou, Paris, France, 4CHU de St-Etienne, INSERM, UMR 1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, INSERM, CIC-1408, Service de Médecine Vasculaire et Thérapeutique, Saint-Etienne, France, 5CHU de Dijon, Service de Médecine Interne, Dijon, France, 6Hôpital de la Cavale Blanche, CHRU de Brest, CIC INSERM 1412, EA 3878 (GETBO), Service de Pneumologie, Brest, France, 7Hôpital Nord-Ouest Villefranche-sur-Saône, Gleize, France, 8APHP, Hôpital Louis Mourier, Médecine Interne, Colombes, France, 9Université de Paris, APHP, Hôpital Louis Mourier, Médecine Interne, Colombes, France, 10Université de Paris, APHP, Hôpital Européen Georges Pompidou, Pneumologie, Paris, France, 11Université de Paris, APHP, Hôpital Louis Mourier, INSERM UMR_S 1140, Innovations Thérapeutiques en Hémostase, Colombes, France

Abstract Number: PB2416

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » VTE Treatment

Background: Few data are available about anticoagulation management beyond 6 months in CAT patients.

Aims: Our objective was to describe anticoagulant modalities beyond 6 months and up to 12 months in CAT patients initially treated with low molecular weight heparin (LMWH).

Methods: CAT patients previously included in two prospective cohort studies (aXa-NCT02898051; PREDICARE – NCT03099031) and still alive at the end of the initial 6-month treatment period were eligible to participate in this retrospective non-interventional French multicenter study.
Main study outcome was to describe anticoagulant treatment in the management of CAT patients in usual medical care from 7th month to 12th month. Clinical outcomes including venous thromboembolism recurrence, bleeding and deaths were presented previously.

Results: Among the 432 patients (aged 66.5±12.7 years) alive after 6 months of anticoagulant therapy for CAT and included in the study, 332 were followed up to 12 months while 96 patients deceased before study end and 4 patients were lost-to follow-up. Anticoagulant modalities were missing for 10 patients.
At 6 months, anticoagulant therapy was stopped in 74 patients, 56 were switched to vitamin K antagonists (VKA) (16.1% [95%CI, 12.4%-20.4]), 30 to direct oral anticoagulants (DOAC) (8.6% [95%CI, 5.9%-12.1]) and 6 to others. LMWHs were maintained in 256 patients (73.6% [95%CI, 68.6-78.1]). Among them, beyond 6 months, LMWHs were definitively discontinued in 86 patients (33.7%), the main reason being a favorable course of the cancer (16 patients, 18.6%), whereas concern about bleeding risk is low (2 patients, 2.3%) patients. Anticoagulation switches from 7 to 12 months are reported in the table.

Conclusions: Anticoagulation with LMWH was maintained beyond 6 months and up to 12 months in the vast majority of patients with CAT. They were in accordance with clinical practice guidelines suggesting that treatment should be maintained as long cancer is active or in the absence of bleeding risk.

Treatment at inclusion (at 6 months from the index event) LMWH (n = 256) VKA (n = 56) DOAC (n = 30)
Median duration beyond 6 months (IQR) 4.6 mo. (2.0-6.0) 6 mo. (5.2-6.0) 6 mo. (5.4-6.0)
Treatment discontinuation from 7 to 12 months [n (%)] 86 (33.7) 12 (21.8) 8 (27.6)
Treatment switch from 7 to 12 months to [n (%)]      
LMWH 7 (2.7) 7 (12.7) 0
VKA 20 (7.8) – 0
DOAC 13 (5.1) 0 –
UFH 2 (0.8) 1 (1.8) 0

[Management of the anticoagulant treatment beyond 6 months (IQR: interquartile range; mo: months)]

To cite this abstract in AMA style:

Plaisance L, Chapelle C, Laporte S, Planquette B, Bertoletti L, Falvo N, Coururaud F, Falchero L, Mahé I, Helfer H, Chidiac J, Meyer G, Mahé I, USCAT Group . Long-Term Management of Anticoagulants in Patients with Cancer-Associated Thrombosis (CAT) Beyond 6 Months: A 432-Patient Retrospective Non-Interventional Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/long-term-management-of-anticoagulants-in-patients-with-cancer-associated-thrombosis-cat-beyond-6-months-a-432-patient-retrospective-non-interventional-study/. Accessed November 30, 2023.

« Back to ISTH 2020 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/long-term-management-of-anticoagulants-in-patients-with-cancer-associated-thrombosis-cat-beyond-6-months-a-432-patient-retrospective-non-interventional-study/

Simple Search

Supported By:

Takeda logo

ISTH 2022 Congress site

Visit the official web site for the ISTH 2022 Virtual Congress »

  • Help & Support
  • About Us
  • Cookies & Privacy
  • Wiley Job Network
  • Terms & Conditions
  • Advertisers & Agents
Copyright © 2023 John Wiley & Sons, Inc. All Rights Reserved.
Wiley