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首页> 外文期刊>Journal of oncology pharmacy practice: official publication of the International Society of Oncology Pharmacy Practitioners >Evaluation of rivaroxaban use in patients with gynecologic malignancies at an academic medical center: A pilot study
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Evaluation of rivaroxaban use in patients with gynecologic malignancies at an academic medical center: A pilot study

机译：在学术医疗中心妇科恶性肿瘤患者中利用昔扎班的评价：试点研究

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Background Patients with gynecologic malignancies are at an increased risk for venous thromboembolism. National guidelines recommend treatment of an acute venous thromboembolism with low molecular weight heparin for 5-10 days followed by long-term secondary prophylaxis with low molecular weight heparin for at least six months. Non-vitamin K oral anticoagulants are not currently recommended to be used in cancer patients for the management of venous thromboembolism because robust data on their efficacy and safety have yet to become available in cancer patients. The objectives of this study were to determine the proportion of gynecologic oncology patients with venous thromboembolism using rivaroxaban compared to warfarin or low molecular weight heparin as well as compare the safety and efficacy of these anticoagulants. Methods This study was a retrospective pilot analysis of adult patients with gynecologic malignancies who received either rivaroxaban, warfarin or low molecular weight heparin for treatment of venous thromboembolism at Augusta University Medical Center from 1 July 2013 to 30 June 2015. Statistical comparisons between the enoxaparin and rivaroxaban group were made using T-tests and Chi-square or Fisher's exact tests, where appropriate. Results Out of the 49 patients, 37% (18) patients were on rivaroxaban, 53% (26) on enoxaparin, and 10% (5) on warfarin. Only one patient (4%) in the enoxaparin group experienced a recurrent deep vein thrombosis while there were no cases of recurrent venous thromboembolism in the rivaroxaban and warfarin group. The incidence of major bleeding was 17% (n = 2), 20% (n = 1), and 8% (n = 2) in patients receiving rivaroxaban, enoxaparin, and warfarin, respectively. The rate of switching to a different anticoagulant than originally prescribed was 42% (n = 14) in the enoxaparin arm, and 5.5% (n = 1) in the rivaroxaban arm. Conclusion A high proportion of our gynecologic oncology patients received rivaroxaban for the management of venous thromboembolism. The sample size of this pilot analysis was too small to draw any conclusions regarding efficacy and safety of rivaroxaban compared with enoxaparin and warfarin. High rate of rivaroxaban use in gynecologic oncology patients at our institution highlights the need for larger, well-designed randomized controlled trials to confirm the safety and efficacy of its use in this population.
机译：背景技术妇科恶性肿瘤的患者处于静脉血栓栓塞的风险增加。国家指导方针建议治疗低分子量肝素急性静脉血栓栓塞5-10天，然后长期二次预防，低分子量肝素至少六个月。目前尚未建议在癌症患者中使用非维生素K口服抗凝血剂，以便管理静脉血栓栓塞，因为患有患者的疗效和安全性的强大数据尚未可用。该研究的目标是使用蓖麻毒素或低分子量肝素的幼稚血栓栓塞患者患有静脉血栓栓塞的比例，并比较这些抗凝血剂的安全性和功效。方法研究本研究是对成年患者的重点试验分析，妇科恶性肿瘤患者接受亚太甘油爪，华法林或低分子量肝素，用于治疗奥古斯塔大学医疗中心的静脉血栓栓塞，2013年7月1日至2015年6月30日。脑诺卡林和脑素之间的统计比较利用RIVAROXABAN组使用T-TESTS和CHI-Square或Fisher的确切测试，在适当的情况下。结果49例患者，37％（18）名患者在甲氧哌沙嗪，53％（26）上，在华法林10％（5）。只有一名患者（4％）在烯脱嗪组中经历了反复性的深静脉血栓形成，而在罗昔扎坎和华法林组中没有反复性静脉血栓栓塞。在接受亚甲氧苯甲苯甲酰甲烷，烯脱蒿素和华法林的患者中，主要出血的发生率为17％（n = 2），20％（n = 1）和8％（n = 2）。切换到不同抗凝血的速度比最初规定的抗氧吲哚·臂中的42％（n = 14），Rivaroxaban臂中的5.5％（n = 1）。结论我们的妇科肿瘤学患者高比例接受了静脉血栓栓塞治疗的rivaroxaban。该试点分析的样本量太小，不能与甲氧辛林和华法林相比，利用蓖麻油的疗效和安全性。我们机构妇科肿瘤学患者在妇科肿瘤患者中使用的高率突出了对更大，精心设计的随机对照试验的需求，以确认其在本人中使用的安全性和功效。

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