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Feasibility of edoxaban for asymptomatic cancer-associated thrombosis in Japanese patients with gastrointestinal cancer : ExCAVE study

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Title: Feasibility of edoxaban for asymptomatic cancer-associated thrombosis in Japanese patients with gastrointestinal cancer : ExCAVE study
Authors: Nakamura, Michio Browse this author
Ishiguro, Atsushi Browse this author
Dazai, Masayoshi Browse this author
Kawamoto, Yasuyuki Browse this author
Yuki, Satoshi Browse this author
Sogabe, Susumu Browse this author
Hosokawa, Ayumu Browse this author
Sawada, Kentaro Browse this author
Muto, Osamu Browse this author
Izawa, Naoki Browse this author
Nakashima, Koji Browse this author
Horie, Yoshiki Browse this author
Yagisawa, Masataka Browse this author
Kajiura, Shinya Browse this author
Ando, Takayuki Browse this author
Mitsuhashi, Yosuke Browse this author
Sunakawa, Yu Browse this author
Kikuchi, Yasuka Browse this author
Komatsu, Yoshito Browse this author →KAKEN DB
Keywords: Thrombosis
Edoxaban
Gastrointestinal cancer
Bleeding
Heparin
Issue Date: 16-Dec-2022
Publisher: BioMed Central
Journal Title: BMC cancer
Volume: 22
Issue: 1
Start Page: 1322
Publisher DOI: 10.1186/s12885-022-10403-y
Abstract: Background: Although initial therapy with a parenteral anticoagulant is required before edoxaban, this strategy is frequently avoided in actual clinical practice because of its complexity. This study assessed the feasibility of edoxaban without initial heparin usage for asymptomatic cancer-associated thrombosis (CAT) in Japanese patients with gastrointestinal cancer (GIC) at high risk of bleeding. Methods: In this multicenter prospective feasibility study conducted at 10 Japanese institutions, patients with active GIC who developed accidental asymptomatic CAT during chemotherapy were recruited. Edoxaban was orally administered once daily without initial parenteral anticoagulant therapy within 3 days after detecting asymptomatic CAT. The primary outcome was the incidence of major bleeding (MB) or clinically relevant non-major bleeding (CRNMB) during the first 3 months of edoxaban administration. Results: Of the 54 patients enrolled from October 2017 to September 2020, one was excluded because of a misdiagnosis of CAT. In the remaining 53 patients, the primary outcome occurred in six patients (11.3%). MB occurred in four patients (7.5%), including gastrointestinal bleeding in three patients and intracranial hemorrhage in one patient. CRNMB occurred in two patients (3.8%), including bleeding from the stoma site and genital bleeding in one patient each. There were no deaths attributable to bleeding, and all patients who experienced MB or CRNMB recovered. Conclusions: The risk of bleeding after edoxaban without heparin pretreatment was acceptable, demonstrating new treatment options for asymptomatic CAT in patients with GIC.
Type: article
URI: http://hdl.handle.net/2115/88085
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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