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2139 Efficacy and Safety of Primary Thromboprophylaxis for the Prevention of Venous Thromboembolism in Patients with Cancer and Central Venous Catheter: A Systematic Review and Meta-AnalysisClinically Relevant Abstract

Program: Oral and Poster Abstracts
Session: 332. Anticoagulation and Antithrombotic Therapies: Poster II
Hematology Disease Topics & Pathways:
Clinical Research
Sunday, December 12, 2021, 6:00 PM-8:00 PM

Allen Li, BHSc1*, Willem Brandt2*, Cameron Brown2*, Tzu-Fei Wang, MD3, Rick Ikesaka, MD4*, Aurelien Delluc, MD, PhD5*, Philip S. Wells, MD, MSc, FRCP2,6,7 and Marc Carrier5

1University of Ottawa/The Ottawa Hospital, Ottawa, ON, Canada
2Ottawa Hospital Research Institute, Ottawa, ON, Canada
3Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
4Department of Medicine, McMaster University, Hamilton, ON, Canada
5Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, ON, Canada
6Department of Medicine, University of Ottawa, Ottawa, ON, Canada
7The Ottawa Hospital, Ottawa Blood Disease Centre, Ottawa, ON, Canada

Background

Venous thromboembolism (VTE) is a leading cause of mortality in patients with cancer and is associated with significant morbidity and healthcare expenditure. The risk of VTE is also increased following the insertion of a central venous catheter (CVC) for chemotherapy deliverance and supportive care. The risks and benefits of primary thromboprophylaxis in patients with cancer and newly inserted CVC are unclear.

Objective

We sought to assess the rates of VTE and major bleeding complications to determine the safety and efficacy of primary thromboprophylaxis in adult patients with cancer and a CVC.

Methods

A systematic search of MEDLINE, EMBASE, and all EBM was conducted. Randomized controlled trials (RCTs) of adult patients with cancer and a CVC receiving primary thromboprophylaxis or observation/placebo were included. The primary efficacy and safety outcomes were total VTE and major bleeding episodes, respectively.

Results

A total of 9 RCTs (3155 patients) were included in the analysis. The total rates of VTE were significantly lower in patients receiving primary thromboprophylaxis compared to those not receiving primary prevention (7.6% vs. 13%; Odds Ratio (OR) 0.51, 95% CI 0.32 to 0.82, p < 0.01, I² = 52%) (Figure 1). The rate of major bleeding complication was not increased in patients receiving thromboprophylaxis (0.9% vs. 0.7%; OR 1.12, 95% CI 0.29 to 4.40, p = 0.87, I² = 32%) (Figure 2).

Conclusions

Primary thromboprophylaxis significantly reduced the risk of VTE without increasing the risk of major bleeding complications in patients with cancer and CVC. Future studies are needed to confirm these findings.

Disclosures: Wang: Leo Pharma: Research Funding; Servier: Membership on an entity's Board of Directors or advisory committees. Ikesaka: LEO Pharma: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees. Wells: Bristol-Myers Squibb: Honoraria; Pfizer: Honoraria; Bayer: Honoraria; BMS/Pfizer: Research Funding; Servier: Honoraria. Carrier: Servier: Honoraria; Boehringer Ingelheim: Honoraria; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees; Aspen: Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Honoraria; Bayer: Honoraria, Membership on an entity's Board of Directors or advisory committees; LEO Pharma: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi Aventis: Honoraria, Membership on an entity's Board of Directors or advisory committees.

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