[Xa因子抑制剂——等同于低分子量肝素用于治疗癌症相关静脉血栓栓塞症]
[Factor Xa inhibitors - equivalent to low molecular weight heparin for the treatment of cancer-associated venous thromboembolism].
作者信息
Magnusson Peter, Mattsson Gustav
机构信息
med dr, överläkare, VO kardiologi, Gävle sjukhus; Cent-rum för forskning och utveckling, Uppsala universitet/Region Gävleborg; institutionen för medicin, Karolinska institutet, Stockholm.
ST-läkare,, internmedicin, Gävle sjukhus, Centrum för forskning och utveckling, Uppsala universitet/ Region Gävleborg.
出版信息
Lakartidningen. 2021 Apr 8;118:20224.
Venous thromboembolism (VTE) is a common cause of morbidity and mortality in cancer patients. Cancer-associated VTE has an increased risk of recurrence and often cancer confers an increased risk of bleeding, which complicates treatment with anticoagulation. Traditionally, patients with cancer-associated VTE was treated with low molecular weight heparin (LMH). In total, 4 randomized controlled trials have compared non-vitamin K antagonist oral anticoagulantia (NOAC) with LMH. The NOACs studied are the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban. A metaanalysis of these 4 trials have shown at least similar efficacy for prevention of new VTE and a similar risk of bleeding.
静脉血栓栓塞症（VTE）是癌症患者发病和死亡的常见原因。癌症相关的VTE复发风险增加，而且癌症往往会增加出血风险，这使得抗凝治疗变得复杂。传统上，癌症相关VTE患者采用低分子量肝素（LMH）治疗。总共有4项随机对照试验比较了非维生素K拮抗剂口服抗凝药（NOAC）与LMH。所研究的NOAC是Xa因子抑制剂阿哌沙班、依度沙班和利伐沙班。对这4项试验的荟萃分析表明，在预防新的VTE方面至少具有相似的疗效，且出血风险相似。
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