Presentation Title

Comparative Effectiveness of Venous Thromboembolism (VTE) Prophylaxis in Patients with Cancer

Speaker Credentials

Ph.D. in Pharmacy

Speaker Credentials

PharmD

College

College of Pharmacy

Location

Nova Southeastern University, Davie, Florida, USA

Format

Podium Presentation

Start Date

16-2-2018 10:45 AM

End Date

16-2-2018 11:15 AM

Abstract

Objective: To evaluate the safety and effectiveness of anticoagulants used for thromboprophylaxis in cancer patients Background: Cancer patients account for 20% of all VTE cases in the United States, and VTE has a more substantial effect on cancer patients than on non-cancer patients. Despite many clinical practice guidelines, the anticoagulant’s effectiveness still remains controversial in cancer patients. Methods: A retrospective comparative effectiveness cohort study was conducted using data from the Medical Expenditure Panel Survey. The incidence of VTE, bleeding, and all-cause death events; and health-related quality of life were used as outcomes to evaluate the two cohorts (prophylactic and matching-control). The effects of age, gender, race, and comorbidities on the clinical outcomes were controlled in logistic regression. Results: The incidence of VTE was higher in the prophylactic cohort than the matching-control (5.6% vs. 2.1%, respectively, with a relative risk (RR) of 2.66, 95%CI 2.64-2.68). Furthermore, there were more bleeding (29% vs. 24%, RR 1.21, 95%CI 1.21-1.22) and all-cause death events (10.13% vs. 6.86%, RR 1.47, 95%CI 1.46-1.48) in the prophylactic cohort than in the matching-control cohort. However, after controlling for the effect of age, gender, race, and comorbidities these differences between the two cohorts became statistically insignificant. The use of thromboprophylaxis was associated with a significant decline in physical quality of life, with no significant impact on mental quality of life. Conclusion: The present study findings support the current guidelines’ recommendation pertaining to VTE prophylaxis in cancer patients by providing evidence on the anticoagulants’ effectiveness for thromboprophylaxis in real-world practice.

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Feb 16th, 10:45 AM Feb 16th, 11:15 AM

Comparative Effectiveness of Venous Thromboembolism (VTE) Prophylaxis in Patients with Cancer

Nova Southeastern University, Davie, Florida, USA

Objective: To evaluate the safety and effectiveness of anticoagulants used for thromboprophylaxis in cancer patients Background: Cancer patients account for 20% of all VTE cases in the United States, and VTE has a more substantial effect on cancer patients than on non-cancer patients. Despite many clinical practice guidelines, the anticoagulant’s effectiveness still remains controversial in cancer patients. Methods: A retrospective comparative effectiveness cohort study was conducted using data from the Medical Expenditure Panel Survey. The incidence of VTE, bleeding, and all-cause death events; and health-related quality of life were used as outcomes to evaluate the two cohorts (prophylactic and matching-control). The effects of age, gender, race, and comorbidities on the clinical outcomes were controlled in logistic regression. Results: The incidence of VTE was higher in the prophylactic cohort than the matching-control (5.6% vs. 2.1%, respectively, with a relative risk (RR) of 2.66, 95%CI 2.64-2.68). Furthermore, there were more bleeding (29% vs. 24%, RR 1.21, 95%CI 1.21-1.22) and all-cause death events (10.13% vs. 6.86%, RR 1.47, 95%CI 1.46-1.48) in the prophylactic cohort than in the matching-control cohort. However, after controlling for the effect of age, gender, race, and comorbidities these differences between the two cohorts became statistically insignificant. The use of thromboprophylaxis was associated with a significant decline in physical quality of life, with no significant impact on mental quality of life. Conclusion: The present study findings support the current guidelines’ recommendation pertaining to VTE prophylaxis in cancer patients by providing evidence on the anticoagulants’ effectiveness for thromboprophylaxis in real-world practice.