Preventing Recurrent Cancer-Associated Thrombosis

Patients with active cancer and venous thromboembolism (VTE) require indefinite anticoagulation yet have high bleeding risk. Offering a possible compromise, the recent 1800-patient API-CAT trial showed that low-dose apixaban (compared with high-dose) resulted in similar 1-year VTE recurrence rates (≈2.5%) and lower rates of clinically relevant bleeding (12% vs. 16%) in patients with cancer-associated thrombosis who had received at least 6 months of high-dose anticoagulant therapy. To examine whether other studies could add to the evidence, researchers conducted a systematic review and meta-analysis.

The researchers identified only one additional relevant randomized trial, a 360-patient study with results similar to those of the much larger API-CAT trial. Thus, the meta-analysis essentially reflects API-CAT's above-noted findings on effectiveness and bleeding.