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ASH 2014:对比亭扎肝素和华法林治疗急性静脉血栓栓塞肿瘤患者的疗效与安全性

2014-12-22 许景红 中国医学论坛报

北京协和医院血液科朱铁楠副教授应记着邀请对当地时间12月9日上午公布的一项关注肿瘤患者抗栓治疗的最新揭晓临床研究(LBA-2)给予了解读。 与非肿瘤患者相比,肿瘤静脉血栓栓塞症(VTE)患者其血栓事件的复发率及抗凝治疗相关出血事件的发生率均显著增加。尽管目前国际指南推荐在肿瘤VTE患者采用低分子量肝素的抗凝治疗,但其临床证据有限。作为迄今为止针对肿瘤VTE患者最大规模的随机对照研究,本研究进一步

北京协和医院血液科朱铁楠副教授应记着邀请对当地时间12月9日上午公布的一项关注肿瘤患者抗栓治疗的最新揭晓临床研究(LBA-2)给予了解读。

与非肿瘤患者相比,肿瘤静脉血栓栓塞症(VTE)患者其血栓事件的复发率及抗凝治疗相关出血事件的发生率均显著增加。尽管目前国际指南推荐在肿瘤VTE患者采用低分子量肝素的抗凝治疗,但其临床证据有限。作为迄今为止针对肿瘤VTE患者最大规模的随机对照研究,本研究进一步证实了低分子量肝素在肿瘤VTE患者抗凝治疗中的优势。

Catch研究(摘要号:LBA-2)是一项在肿瘤患者中对比亭扎肝素(tinzaparin)和华法林治疗急性静脉血栓栓塞症(VTE)的疗效与安全性的全球多中心Ⅲ期随机对照研究。

该研究共纳入了900例急性症状性近端深静脉血栓形成(DVT)和/或肺栓塞(PE)的肿瘤患者,随机分别接受6个月亭扎肝素(n=449)或亭扎肝素与华法林的序贯抗凝治疗(n=451)。

在抗凝治疗期间,亭扎肝素治疗组和华法林治疗组分别有31例(6.9%)患者和45例(10%)患者出现了复发性VTE事件。尽管亭扎肝素与华法林相比,其降低复发性VTE的疗效未达到统计学显著性差异,但亭扎肝素可显著减少症状性DVT的发生。症状性非致死性DVT的发生率在亭扎肝素组和华法林组分别为2.7%和5.3%[风险比(HR)0.48,95% 可信区间(CI) 0.24~0.96,P=0.04]。研究显示两组患者的病死率或严重出血事件发生率并无明显差异,但亭扎肝素治疗组患者有临床意义的非严重出血事件(11%)明显少于华法林组(16%)(P=0.03)。

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    2015-11-03 fusion
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    2015-03-04 xiaoai5777

    超赞,好文章

    0

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    2015-11-08 xue8602
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    2014-12-24 kksonne
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