Bertoletti Laurent, Gusto Gaelle, Quignot Nadia, Khachatryan Artak, Chaves Jose, Moniot Audrey, Mokgokong Ruth, Mahé Isabelle
Université Jean Monnet Saint-Étienne, CHU Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, CIC 1408, Département of Médecine Vasculaire et Thérapeutique, F-42023 Saint-Etienne, France.
Certara France, 75008 Paris, France.
Cancers (Basel). 2023 May 31;15(11):3011. doi: 10.3390/cancers15113011.
Patients with cancer have an increased risk of developing venous thromboembolism (VTE) and an increased risk of death from VTE. Until recently, the standard of care for treatment of VTE in cancer patients was low molecular weight heparins (LMWH). To determine treatment patterns and outcomes, we performed an observational study using a nationwide health database. Treatment patterns, rates of bleeding, and VTE recurrence at 6 and 12 months were assessed in cancer patients with VTE in France prescribed LMWH in 2013-2018. Of 31,771 patients administered LMWH (mean age 66.3 years), 51.0% were male, 58.7% had pulmonary embolism, and 70.9% had metastatic disease. At 6 months LMWH persistence was 81.6%, VTE recurrence had occurred in 1256 patients (4.0%) at a crude rate per 100 person-months (PM) of 0.90, and bleeding had occurred in 1124 patients (3.5%) at a crude rate per 100 PM of 0.81. At 12 months, VTE recurrence had occurred in 1546 patients (4.9%) at a crude rate per 100 PM of 0.71 and bleeding had occurred in 1438 patients (4.5%) at a crude rate per 100 PM of 0.66. Overall, VTE-related clinical event rates were high among patients administered LMWH, suggesting an unmet medical need.
癌症患者发生静脉血栓栓塞（VTE）的风险增加，且因VTE导致死亡的风险也增加。直到最近，癌症患者VTE治疗的标准护理方法还是低分子量肝素（LMWH）。为了确定治疗模式和结果，我们使用全国性健康数据库进行了一项观察性研究。对2013年至2018年在法国接受LMWH治疗的VTE癌症患者的治疗模式、出血率以及6个月和12个月时的VTE复发情况进行了评估。在31771名接受LMWH治疗的患者（平均年龄66.3岁）中，51.0%为男性，58.7%患有肺栓塞，70.9%患有转移性疾病。6个月时LMWH持续使用率为81.6%，1256名患者（4.0%）发生了VTE复发，每100人月（PM）的粗复发率为0.90，1124名患者（3.5%）发生了出血，每100 PM的粗出血率为0.81。12个月时，1546名患者（4.9%）发生了VTE复发，每100 PM的粗复发率为0.71，1438名患者（4.5%）发生了出血，每100 PM的粗出血率为0.66。总体而言，接受LMWH治疗的患者中VTE相关临床事件发生率较高，表明存在未满足的医疗需求。
