Show simple item record

dc.contributor.authorSamaranayake, Chinthaka B
dc.contributor.authorAnderson, James
dc.contributor.authorMcCabe, Colm
dc.contributor.authorZahir, Syeda Farah
dc.contributor.authorUpham, John
dc.contributor.authorKeir, Gregory
dc.date.accessioned2020-09-21T04:51:22Z
dc.date.available2020-09-21T04:51:22Z
dc.date.issued2020
dc.identifier.issn1444-0903en_US
dc.identifier.doi10.1111/imj.15049en_US
dc.identifier.urihttp://hdl.handle.net/10072/397724
dc.description.abstractBACKGROUND: Several recent randomized controlled trials (RCTs) have investigated the use of direct oral anticoagulants (DOACs) in the treatment of malignancy associated venous thromboembolisms (VTE). AIMS: This meta-analysis combines all RCT data to determine the risks of recurrent VTE and bleeding with DOACs in patients with malignancy associated VTE compared to low molecular weight heparin (LMWH). METHODS: The study followed PRISMA guidelines. MEDLINE, EMBASE, CENTRAL were systematically searched from inception to 1st of April 2020. References of reviews and relevant conference proceedings were hand-searched. Two authors independently evaluated study eligibility, extracted data, and assessed risk-of-bias. Direct and indirect meta-analyses were performed. RESULTS: In four RCTs with low risk-of-bias (2907 patients), high certainty evidence suggested that DOACs had a 37% reduction in risk of recurrent VTE compared to LMWH (direct pooled risk ratio (RR) 0.63, 95%CI 0.44-0.91; I2 = 28%). No significant difference was observed in the risk of major bleeding with DOACs compared to LMWH (RR 1.31, 95%CI 0.83-2.07; I2 = 22%; moderate certainty evidence), including in patients in gastrointestinal and genitourinary malignancy. An increased risk of combined major or CRNMB was seen with DOACs (RR 1.52, 95%CI 1.09-2.12; I2 = 51%; low certainty evidence). Apixaban had the highest probability of being ranked most effective and least bleeding risk amongst the DOACs. CONCLUSION: DOACs are effective in treating malignancy associated VTE, however caution is required in patients with high risk of bleeding. Apixaban had lower risk of bleeding compared to other DOACs in this population.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglish
dc.language.isoeng
dc.publisherWileyen_US
dc.relation.ispartofjournalInternal Medicine Journalen_US
dc.subject.fieldofresearchCardiorespiratory Medicine and Haematologyen_US
dc.subject.fieldofresearchClinical Sciencesen_US
dc.subject.fieldofresearchPublic Health and Health Servicesen_US
dc.subject.fieldofresearchcode1102en_US
dc.subject.fieldofresearchcode1103en_US
dc.subject.fieldofresearchcode1117en_US
dc.subject.keywordsHeparin, Low-Molecular-Weighten_US
dc.subject.keywordsVenous thromboemolismsen_US
dc.subject.keywordsfactor Xa Inhibitors, direct oral anticoagulantsen_US
dc.subject.keywordsneoplasmen_US
dc.subject.keywordspulmonary embolismen_US
dc.titleDirect oral anticoagulants for cancer associated venous thromboembolisms: a systematic review and network meta-analysisen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationSamaranayake, CB; Anderson, J; McCabe, C; Zahir, SF; Upham, J; Keir, G, Direct oral anticoagulants for cancer associated venous thromboembolisms: a systematic review and network meta-analysis, Internal Medicine Journal, 2020en_US
dcterms.dateAccepted2020-08-30
dc.date.updated2020-09-21T04:41:55Z
dc.description.versionAccepted Manuscript (AM)en_US
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.en_US
gro.rights.copyright© 2020 Royal Australasian College of Physicians. This is the peer reviewed version of the following article: Direct oral anticoagulants for cancer associated venous thromboembolisms: a systematic review and network meta-analysis, Internal Medicine Journal, 2020, which has been published in final form at https://doi.org/10.1111/imj.15049. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)en_US
gro.hasfulltextFull Text
gro.griffith.authorAnderson, James


Files in this item

This item appears in the following Collection(s)

  • Journal articles
    Contains articles published by Griffith authors in scholarly journals.

Show simple item record