癌症相关血栓形成患者抗凝药物的处方模式：MITO 小组和 AIOM 学会调查结果。
Prescribing pattern of anticoagulants in patients with cancer associated thrombosis: Results of a survey among MITO group and AIOM society.
机构信息
Pronto Soccorso, Ospedale San Lorenzo, ASL TO5, Turin, Italy.
Department of Oncology, University of Turin, Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy.
出版信息
Tumori. 2023 Oct;109(5):490-495. doi: 10.1177/03008916221146820. Epub 2023 Jan 6.
INTRODUCTION
Low molecular weight heparin (LMWH) has been the backbone of the treatment of cancer associated thrombosis (CAT). Direct-acting oral anticoagulants (DOACs) have shown efficacy and safety not inferior to LMWH and guidelines included DOACs as an option for CAT treatment. Nevertheless, DOACs are still poorly prescribed in patients with cancer. The aim of this survey was to better understand prescription patterns of anticoagulants, in particular of DOACs, especially in gynecological cancers (GCs).
METHODS
Our survey was made up of 21 questions, the last four questions addressed to medical doctors (MDs) involved in GCs. An invitation to complete the survey was sent by e-mail to 691 MITO (Multicentre Italian Trials in Ovarian cancer and gynaecologic malignancies) and 2093 AIOM (Associazione Italiana di Oncologia Medica) members.
RESULTS
Overall, 113 MDs completed the questionnaire, 69 involved in GCs. Most respondents (46, 41%) were aged 30-40 years old, worked in public hospitals (59, 52.2%), were medical oncologists (86, 76.1%). LMWH was the preferred choice for the treatment of CAT (104, 92%). However, 89 respondents (78.8%) prescribed or asked to prescribe a DOAC for CAT. The major concern about DOACs was the difficulty in verifying the therapeutic effect and the absence of antidotes in case of bleeding (37.9%). In patients with GCs, DOACs were used with niraparib, olaparib, rucaparib and immune checkpoint inhibitors (ICIs) in less than 10 patients by 23%, 20%, 9% and 10.2% of respondents, respectively.
CONCLUSION
The responders are aware of the Direct-acting oral anticoagulants option and would like to use them.
简介
低分子量肝素（LMWH）一直是癌症相关血栓形成（CAT）治疗的基础。直接作用的口服抗凝剂（DOAC）已显示出不劣于 LMWH 的疗效和安全性，指南将 DOAC 纳入 CAT 治疗的选择。然而，癌症患者对 DOAC 的使用仍不理想。本调查旨在更好地了解抗凝剂的处方模式，特别是 DOAC 的处方模式，特别是在妇科癌症（GCs）中。
方法
我们的调查由 21 个问题组成，最后四个问题针对参与 GCs 的医生（MDs）。通过电子邮件向 691 名 MITO（多中心意大利卵巢癌和妇科恶性肿瘤试验）和 2093 名 AIOM（意大利肿瘤医学协会）成员发送了完成调查的邀请。
结果
共有 113 名 MD 完成了问卷，其中 69 名参与了 GCs。大多数受访者（46，41%）年龄在 30-40 岁之间，在公立医院工作（59，52.2%），是肿瘤内科医生（86，76.1%）。LMWH 是治疗 CAT 的首选药物（104，92%）。然而，89 名受访者（78.8%）开处方或要求开 DOAC 治疗 CAT。关于 DOAC 的主要顾虑是难以验证治疗效果，以及在出血时缺乏解毒剂（37.9%）。在 GC 患者中，23%、20%、9%和 10.2%的受访者分别在不到 10 例患者中使用 DOAC 与尼拉帕尼、奥拉帕利、鲁卡帕利和免疫检查点抑制剂（ICIs）联合治疗。
结论
应答者意识到直接作用的口服抗凝剂的选择，并希望使用它们。
Zotero 插件