Alexander Cohen1, Allison Keshishian2, Theodore Lee3, Gail Wygant4, Lisa Rosenblatt4, Patrick Hlavacek3, Jack Mardekian3, Daniel Wiederkehr3, Janvi Sah2, Xuemei Luo5. 1. Department of Hematological Medicine, Guy's & St Thomas' NHS Foundation Trust, King's College London, Westminster Bridge Road, London, United Kingdom. 2. SIMR, LLC, Ann Arbor, Michigan, United States. 3. Pfizer Inc., New York, New York, United States. 4. Bristol-Myers Squibb Company, Lawrenceville, New Jersey, United States. 5. Pfizer Inc., Groton, Connecticut, United States.
Abstract
BACKGROUND: This study primarily evaluates the risk of recurrent venous thromboembolism (VTE) and major bleeding (MB) among patients with VTE and active cancer prescribed apixaban, low-molecular-weight heparin (LMWH), or warfarin, with claims data. METHODS: Four U.S. commercial insurance claims databases were used to identify patients with VTE and active cancer who initiated apixaban, LMWH, or warfarin within 30 days following the first VTE event. Stabilized inverse-probability treatment weighting (IPTW) was used to balance treatment cohorts. Cox proportional hazard models were used to evaluate risk of recurrent VTE and MB. RESULTS: All eligibility criteria were fulfilled by 3,393 apixaban, 6,108 LMWH, and 4,585 warfarin patients. After IPTW, all patient characteristics were balanced. When the follow-up was censored at 6 months, apixaban patients had a lower risk of recurrent VTE (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.47-0.81) and MB (HR: 0.63; 95% CI: 0.47-0.86) versus LMWH. Apixaban patients had a lower risk of recurrent VTE (HR: 0.68; 95% CI: 0.52-0.90) and similar risk of MB (HR: 0.73; 95% CI: 0.53-1.00) versus warfarin. Warfarin patients had a similar risk of recurrent VTE (HR: 0.91; 95% CI: 0.72-1.15) and MB (HR: 0.87; 95% CI: 0.68-1.12) versus LMWH. The trends were similar for the entire follow-up; however, apixaban patients had a lower risk of MB versus warfarin patients. CONCLUSION: Patients with VTE and active cancer who initiated apixaban had a lower risk of recurrent VTE and MB compared with LMWH patients. Apixaban patients also had a lower risk of recurrent VTE compared with warfarin patients. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
BACKGROUND: This study primarily evaluates the risk of recurrent venous thromboembolism (VTE) and major bleeding (MB) among patients with VTE and active cancer prescribed apixaban, low-molecular-weight heparin (LMWH), or warfarin, with claims data. METHODS: Four U.S. commercial insurance claims databases were used to identify patients with VTE and active cancer who initiated apixaban, LMWH, or warfarin within 30 days following the first VTE event. Stabilized inverse-probability treatment weighting (IPTW) was used to balance treatment cohorts. Cox proportional hazard models were used to evaluate risk of recurrent VTE and MB. RESULTS: All eligibility criteria were fulfilled by 3,393 apixaban, 6,108 LMWH, and 4,585 warfarinpatients. After IPTW, all patient characteristics were balanced. When the follow-up was censored at 6 months, apixabanpatients had a lower risk of recurrent VTE (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.47-0.81) and MB (HR: 0.63; 95% CI: 0.47-0.86) versus LMWH. Apixabanpatients had a lower risk of recurrent VTE (HR: 0.68; 95% CI: 0.52-0.90) and similar risk of MB (HR: 0.73; 95% CI: 0.53-1.00) versus warfarin. Warfarinpatients had a similar risk of recurrent VTE (HR: 0.91; 95% CI: 0.72-1.15) and MB (HR: 0.87; 95% CI: 0.68-1.12) versus LMWH. The trends were similar for the entire follow-up; however, apixabanpatients had a lower risk of MB versus warfarinpatients. CONCLUSION:Patients with VTE and active cancer who initiated apixaban had a lower risk of recurrent VTE and MB compared with LMWHpatients. Apixabanpatients also had a lower risk of recurrent VTE compared with warfarinpatients. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Authors: Rodrigo Abensur Athanazio; José Manuel Ceresetto; Luis Javier Marfil Rivera; Gabriela Cesarman-Maus; Kenny Galvez; Marcos Arêas Marques; Aldo Hugo Tabares; Carlos Alberto Ortiz Santacruz; Fernando Costa Santini; Luis Corrales; Alexander T Cohen Journal: Clin Appl Thromb Hemost Date: 2022 Jan-Dec Impact factor: 2.389
Authors: Alexander T Cohen; Janvi Sah; Amol D Dhamane; Theodore Lee; Lisa Rosenblatt; Patrick Hlavacek; Birol Emir; Allison Keshishian; Huseyin Yuce; Xuemei Luo Journal: PLoS One Date: 2022-09-23 Impact factor: 3.752