Fondaparinux in the initial and long-term treatment of venous thromboembolism.
Details
Serval ID
serval:BIB_3CA9EFD56CCA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Fondaparinux in the initial and long-term treatment of venous thromboembolism.
Journal
Thrombosis Research
Working group(s)
RIETE Investigators
Contributor(s)
Adarraga MD., Alvarado AV., Arcelus JI., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Benítez JF., Blanco-Molina A., Casado I., Conget F., Chaves EL., de Ancos C., de Ancos C., del Molino F., del Toro J., Falgá C., Farfán AI., Fernández-Capitán C., Font L., Gallego P., García-Bragado F., Gómez V., González J., González-Marcano D., Grau E., Guijarro R., Gutiérrez J., Hernández L., Hernández-Huerta S., Jara-Palomares L., Jaras MJ., Jiménez D., Lecumberri R., Lobo JL., López-Jiménez L., López-Montes L., López-Reyes R., López-Sáez JB., Lorente MA., Lorenzo A., Luque JM., Madridano O., Marchena PJ., Martín-Antorán JM., Mellado M., Monreal M., Morales MV., Nauffal D., Nieto JA., Núñez MJ., Otero R., Pagán B., Pedrajas JM., Peris ML., Pons I., Porras JA., Puerta P., Riera-Mestre A., Rivas A., Rodríguez-Dávila MA., Román P., Rosa V., Ruiz-Giménez N., Ruiz J., Samperiz A., Sánchez R., Soler S., Soto MJ., Suriñach JM., Tiberio G., Tilvan RM., Tirado R., Trujillo-Santos J., Uresandi F., Valero B., Valle R., Vela J., Villalobos A., Malfante P., Matías V., Vivero F., Verhamme P., Peerlinck K., Wells P., Malý R., Hirmerova J., Salgado E., Bertoletti L., Bura-Riviere A., Moustafa F., Farge-Bancel D., Hij A., Mahe I., Merah A., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Zeltser D., Amitrano M., Apollonio A., Barillari G., Cannavaccioulo F., Ciammaichella M., Dentali F., Di Micco P., Enea I., Guida A., Maida R., Pace F., Pasca S., Pesavento R., Piovella C., Prandoni P., Rota L., Tiraferri E., Tufano A., Visonà A., Mesquita P., Ribeiro de Almeida JL. , Sousa MS., Bosevski M., Zdraveska M., Alatri A., Bounameaux H., Calanca L., Mazzolai L., Serrano JC.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
135
Number
2
Pages
311-317
Language
english
Notes
Alatri A. is a RIETE investigator
Abstract
BACKGROUND: Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice.
METHODS: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer.
RESULTS: Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05).
CONCLUSIONS: An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients.
METHODS: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer.
RESULTS: Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05).
CONCLUSIONS: An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients.
Keywords
Anticoagulants/administration & dosage, Anticoagulants/therapeutic use, Female, Humans, Male, Middle Aged, Polysaccharides/administration & dosage, Polysaccharides/therapeutic use, Treatment Outcome, Venous Thromboembolism/drug therapy
Pubmed
Web of science
Create date
12/02/2016 13:59
Last modification date
28/05/2020 5:26
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