Arterial events in cancer patients treated with apixaban for venous thrombosis

Trine-Lise Larsen & Anders Erik Astrup Dahm et al. · 2023-05-25

In a recent interventional study of cancer patients with newly diagnosed venous thrombosis (VT), we found a high risk of arterial thrombotic events (AT) during treatment with therapeutic doses of apixaban. Total 298 cancer patients with VT received apixaban as treatment and secondary prophylaxis for up to 36 months. AT was registered as a serious adverse event, and this is a post hoc analysis of risk factors for AT. Clinical risk factors and concomitant medication were assessed through odds ratios (OR) with 95 % confidence interval using multivariate logistic regression. Biomarkers were assessed by non-parametric testing. AT occurred in 16/298 patients (5.4 %, 95 % confidence interval (CI) 3.1-8.6 %). Median leucocyte count at baseline was higher in patients with AT compared with patients without AT (11 vs. 6.8·10 In cancer patients with apixaban treated VT, pancreatic cancer was strongly associated with AT. In addition, ovarian cancer, BMI < 25 percentile, previous VT, antiplatelet treatment, non-steroidal anti-inflammatory drug use and high leucocyte count at baseline were associated with AT. The CAP study is registered with the unique identifier NCT02581176 in ClinicalTrials.gov.
Authors
Trine-Lise Larsen, Marte Svalastoga, Jorunn Brekke, Tone Enden, Hege Frøen, Herish Garresori, Eva Marie Jacobsen, Petter Quist Paulsen, Alina Carmen Porojnicu, Anne Hansen Ree, Dag Torfoss, Elin Osvik Velle, Hilde Skuterud Wik, Waleed Ghanima, Per Morten Sandset, Anders Erik Astrup Dahm