Oral anticoagulation for prolonging survival in patients with cancer

Oral anticoagulation is not effective for prolonging survival in patients with cancer.

A Cochrane review included 7 studies with a total of 1 805 subjects. The oral anticoagulant was warfarin in 6 studies and apixaban in 1 study, and the comparator was either placebo or no intervention. The use of warfarin had no effect on mortality at 6 months (RR 0.98, 95% CI 0.82 to 1.22), one year (RR 0.97, 95% CI 0.89 to 1.04), 2 years (RR 0.98, 95% CI 0.81 to 1.18), or 5 years (RR 0.92, 95% CI 0.83 to 1.01). One study assessed the effect of warfarin on venous thromboembolism and did not show or exclude a beneficial or detrimental of effect (RR 0.15, 95% CI 0.02 to 1.20). Warfarin increased both major bleeding (RR 4.24, 95% CI 1.86 to 9.65) and minor bleeding (RR 3.19, 95% CI 1.83 to 5.55).

The study assessing the effect of apixaban did not show or exclude a beneficial effect or detrimental of apixaban on mortality at 6 months (RR 0.16, 95% CI 0.01 to 1.66); major bleeding (RR 0.62, 95% CI 0.06 to 6.63); and minor bleeding (RR 2.87, 95% CI 0.16 to 51.82).

Ədəbiyyat

1. Akl EA, Kahale L, Terrenato I et al. Oral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulation. Cochrane Database Syst Rev 2014;(7):CD006466.