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Long-Term Use of Tinzaparin for the Treatment of Cancer-Associated Thrombosis: A Subgroup Analysis of the Prospective Observational TROPIQUE Study

1Assistance Publique - Hôpitaux de Paris, Paris, France, 2Sorbonne Université, Paris, France, 3Institut Sainte Catherine, Avignon, France, 4Leo Pharma, Voisins Le Bretonneux, France, 5CHU de Dijon, Dijon, France, 6CHU de Rouen, Rouen, France, 7CHU d'Amiens, Amiens, France, 8Université de Paris, Paris, France, 9McGill University, Montreal, Canada

Abstract Number: PB2114

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis

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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