[Venous thromboembolic complications in oncological patients: present-day possibilities of effective and safe anticoagulant therapy].

Venoznye tromboémbolicheskie oslozhneniia u onkologicheskikh bol'nykh - sovremennye vozmozhnosti éffektivnoĭ i bezopasnoĭ antikoaguliantnoĭ terapii.

Publisher: Izd-vo Info-Media Country of Publication: Russia (Federation) NLM ID: 9604504 Publication Model: Print Cited Medium: Print ISSN: 1027-6661 (Print) Linking ISSN: 10276661 NLM ISO Abbreviation: Angiol Sosud Khir

Original Publication: [Moskva] : Izd-vo Info-Media, c1995-

Anticoagulants*/therapeutic use ; Thromboembolism*/drug therapy; Administration, Oral ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Humans ; Rivaroxaban

Cancer-associated thromboembolic complications in malignant neoplasms are commonly encountered. They deteriorate the course of the underlying disease and are frequent causes of death. The oncological patient is at high risk of not only thrombosis but haemorrhage during anticoagulant therapy. Recent randomized clinical trials have positively appreciated the possibilities of direct oral anticoagulants in treatment and prevention of thromboses in oncological patients. Analysing subgroups in these studies demonstrated that direct oral anticoagulants during long-term administration were at least as effective and safe as vitamin K antagonists. The most significant by the number of cases, duration of therapy, and methodology of analysis are the reports regarding rivaroxaban - an oral, direct factor Xa inhibitor. There are also findings obtained in a separate randomized study, confirming efficacy and safety of rivaroxaban in treatment of patients with cancer-associated venous thromboembolic complications as compared with therapy with low-molecular-weight heparins. Namely these results formed the basis for the guidelines of the International Society on Thrombosis and Hemostasis (SSC ISTH), according to which rivaroxaban may be regarded as an alternative to low-molecular-weight heparins in certain clinical situations.

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Keywords: direct oral anticoagulants; low-molecular-weight heparins; malignant neoplasms; venous thrombolytic complications
Local Abstract: [Publisher, Russian] Онкоассоциированные венозные тромбоэмболические осложнения при злокачественных новообразованиях встречаются часто, ухудшают течение основной патологии и являются распространенной причиной смерти. Онкологический больной обладает не только высоким риском тромбообразования, но и кровотечений в ходе антикоагулянтной терапии. Последние рандомизированные клинические испытания положительно оценивают возможности прямых оральных антикоагулянтов в лечении и профилактике тромбозов у онкологических пациентов. Анализ подгрупп в этих исследованиях указывает, что прямые оральные антикоагулянты при долговременном использовании как минимум так же эффективны и безопасны, как антагонисты витамина К. Наиболее значим по количеству наблюдений, срокам терапии и методологии анализа материал, относящийся к ривароксабану – прямому пероральному ингибитору Ха фактора. Также есть данные, полученные в отдельном рандомизированном исследовании, подтверждающие эффективность и безопасность терапии ривароксабаном пациентов с онкоассоциированными венозными тромбоэмболическими осложнениями по сравнению с терапией низкомолекулярными гепаринами. Именно эти результаты легли в основу рекомендаций международного общества тромбоза и гемостаза (SSC ISTH), в соответствии с которыми ривароксабан может рассматриваться как альтернатива низкомолекулярным гепаринам в определенных клинических ситуациях.

0 (Anticoagulants)
0 (Heparin, Low-Molecular-Weight)
9NDF7JZ4M3 (Rivaroxaban)

Date Created: 20190418 Date Completed: 20190814 Latest Revision: 20200803

20221213

10.33529/angio2019102

30994603