Abstract Number: PB2114
Meeting: ISTH 2020 Congress
Background: Real word data on the efficacy and safety of long-term use of tinzaparin for the treatment of cancer-associated thrombosis (CAT) are scarce.
Aims: To evaluate the benefit-risk ratio of long-term use of tinzaparin in patients with CAT and whether clinical outcomes differ according to the cancer sites.
Methods: We performed a subgroup analysis of all active cancer patients included in the previously published prospective multicenter observational TROPIQUE study who received long-term tinzaparin treatment. Main outcome was adherence to clinical practice guidelines (CPGs) based on recommended low-molecular-weight heparin treatment doses for at least 3 months in the absence of severe renal insufficiency.
Results: 301 patients were included in this subgroup analysis. At study entry, their mean age was 64.6±11.9 years and 143 (47.5%) patients were men. The most frequent cancer type was gastrointestinal (24.3%), followed by breast (18.3%) and lung (15.3%) cancer. One hundred and seventy-four (57.8%) patients had metastatic disease and 245 (82%) were receiving chemotherapy at time of CAT diagnosis. The most frequent VTE were deep vein thrombosis (47.8%) and pulmonary embolism (32.2%). Mean tinzaparin treatment duration was 5.0±1.9 months. At 6 months of follow-up, the adherence rate to CPGs was 72.8%. Over 6 months of follow-up, the overall incidence of recurrent VTE was 6.0%, while the overall incidence of major bleeding was 6.6%. Recurrent VTE (9.3%) and major bleeding (9.3%) tend to be more frequent in lung cancer patients compared to other cancer patients, although not statistically significant. A high incidence of major bleeding was also observed in hematopoietic cancer patients (9.8%).
Conclusions: This subgroup analysis of TROPIQUE confirms the favorable benefit-risk ratio of tinzaparin for the long-term treatment of CAT. Clinical outcomes may differ according to the cancer site and individualized anticoagulation strategies are warranted in some cases.
To cite this abstract in AMA style:Frere C, Debourdeau P, Lamblin A, Falvo N, Benhamou Y, Sevestre M-, Farge D. Long-Term Use of Tinzaparin for the Treatment of Cancer-Associated Thrombosis: A Subgroup Analysis of the Prospective Observational TROPIQUE Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/long-term-use-of-tinzaparin-for-the-treatment-of-cancer-associated-thrombosis-a-subgroup-analysis-of-the-prospective-observational-tropique-study/. Accessed November 29, 2023.
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