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Erschienen in: best practice onkologie 5/2016

26.09.2016 | Direkte orale Antikoagulanzien | Topic

Direkte orale Antikoagulanzien bei Tumorpatienten — eine Alternative?

verfasst von: Dr. Frank Breywisch

Erschienen in: best practice onkologie | Ausgabe 5/2016

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Auszug

Thromboembolien sind häufige Komplikationen bei Malignomerkrankungen und die zweithäufigste Todesursache nach dem Fortschreiten der Tumorerkrankung. Sie gehen mit einer höheren Rate an Rezidivthromboembolien sowie Blutungsereignissen einher und sind mit einem schlechteren Gesamtüberleben assoziiert. Die in den letzten Jahren zugelassenen, neuen direkten oralen Antikoagulanzien (DOAK) stellen eine Alternative zu den herkömmlichen Therapieoptionen dar. Inwieweit die Substanzen auch bei Tumorpatienten unproblematisch eingesetzt werden können und was dabei zu beachten ist, soll im Folgenden beleuchtet werden. …
Literatur
1.
Zurück zum Zitat Baron TH, Kamath PS (2013) Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med 368:2113–2124CrossRefPubMed Baron TH, Kamath PS (2013) Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med 368:2113–2124CrossRefPubMed
2.
Zurück zum Zitat Baron TH, Kamath PS (2014) New anticoagulant and anti platelet agents: a primer for the gastroenterologist. Clin Gastroenterol Hepatol 12:187–195CrossRefPubMed Baron TH, Kamath PS (2014) New anticoagulant and anti platelet agents: a primer for the gastroenterologist. Clin Gastroenterol Hepatol 12:187–195CrossRefPubMed
3.
Zurück zum Zitat Bauer KA (2013) Pros and cons of new oral anticoagulants. Hematol Am Soc Hematol Educ Program:464–470 Bauer KA (2013) Pros and cons of new oral anticoagulants. Hematol Am Soc Hematol Educ Program:464–470
4.
Zurück zum Zitat Burnett AE, Mahan CE (2016) Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis 41:206–232CrossRefPubMedPubMedCentral Burnett AE, Mahan CE (2016) Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis 41:206–232CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Carrier M, Cameron C (2014) Efficacy and safety of anticoagulant therapy for the treatment of acute cancer-associated thrombosis: a systematic review and meta-analysis. Thromb Res 134(6):1214–1219CrossRefPubMed Carrier M, Cameron C (2014) Efficacy and safety of anticoagulant therapy for the treatment of acute cancer-associated thrombosis: a systematic review and meta-analysis. Thromb Res 134(6):1214–1219CrossRefPubMed
6.
Zurück zum Zitat Francis CW, Kessler CM (2015) Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. J Thromb Haemost 13(6):1028–1035CrossRefPubMed Francis CW, Kessler CM (2015) Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. J Thromb Haemost 13(6):1028–1035CrossRefPubMed
7.
Zurück zum Zitat Gerson LB, Michaels L (2010) Adverse events associated with anticoagulation therapy in the periendoscopic period. Gastrointest Endosc 71:1211–1217CrossRefPubMed Gerson LB, Michaels L (2010) Adverse events associated with anticoagulation therapy in the periendoscopic period. Gastrointest Endosc 71:1211–1217CrossRefPubMed
8.
Zurück zum Zitat Glund S, Stangier J (2014). Idarucizumab, a specific antidote for dabigatran: immediate, complete and sustained reversal of dabigatran induced anticoagulation in elderly and renally impaired subjects. ASH 2014, Abstract 344 Glund S, Stangier J (2014). Idarucizumab, a specific antidote for dabigatran: immediate, complete and sustained reversal of dabigatran induced anticoagulation in elderly and renally impaired subjects. ASH 2014, Abstract 344
9.
Zurück zum Zitat Gong IY, Kim RB (2013) Importance of pharmacokinetic profile and variability as determinants of dose and response to dabigatran, rivaroxaban, and apixaban. Can J Cardiol 29:S24–33CrossRefPubMed Gong IY, Kim RB (2013) Importance of pharmacokinetic profile and variability as determinants of dose and response to dabigatran, rivaroxaban, and apixaban. Can J Cardiol 29:S24–33CrossRefPubMed
10.
Zurück zum Zitat Healey JS, Eikelboom J (2012) Periprocedural bleeding and thromboembolic events with dabigatran compared with warfarin: results from the randomized evaluation of longterm anticoagulation therapy (RE-LY) randomized trial. Circulation 126:343–348CrossRefPubMed Healey JS, Eikelboom J (2012) Periprocedural bleeding and thromboembolic events with dabigatran compared with warfarin: results from the randomized evaluation of longterm anticoagulation therapy (RE-LY) randomized trial. Circulation 126:343–348CrossRefPubMed
11.
Zurück zum Zitat Khorona AA, Carrier M (2016) Guidance for the prevention and treatment of cancer-associated venous thromboembolism. J Throm Thrombolysis 41:81–91CrossRef Khorona AA, Carrier M (2016) Guidance for the prevention and treatment of cancer-associated venous thromboembolism. J Throm Thrombolysis 41:81–91CrossRef
12.
Zurück zum Zitat Lange CM, Fichtlscherer S (2016) The periprocedural management of anticoagulation and platelet aggregation inhibitors in endoscopic interventions. Dtsch Arztebl Int 113:129–135PubMedPubMedCentral Lange CM, Fichtlscherer S (2016) The periprocedural management of anticoagulation and platelet aggregation inhibitors in endoscopic interventions. Dtsch Arztebl Int 113:129–135PubMedPubMedCentral
13.
Zurück zum Zitat Lee AY, Bauersachs R, CATCH Investigators (2013) CATCH: a randomised clinical trial comparing long-term tinzaparin versus warfarin for treatment of acute venous thromboembolism in cancer patients. BMC Cancer 13:284 Lee AY, Bauersachs R, CATCH Investigators (2013) CATCH: a randomised clinical trial comparing long-term tinzaparin versus warfarin for treatment of acute venous thromboembolism in cancer patients. BMC Cancer 13:284
14.
Zurück zum Zitat Lee AY, Kamphuisen PW, CATCH Investigators (2015) Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: a randomized clinical trial. JAMA 314(7):677–686 Lee AY, Kamphuisen PW, CATCH Investigators (2015) Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: a randomized clinical trial. JAMA 314(7):677–686
15.
Zurück zum Zitat Lee AY1, Levine MN et al, Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer (CLOT) Investigators (2003) Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 349(2):146–153 Lee AY1, Levine MN et al, Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer (CLOT) Investigators (2003) Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 349(2):146–153
16.
Zurück zum Zitat Lyman GH, Khorana AA et al, American Society of Clinical Oncology Clinical Practice (2013) Venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 31:2189–2204 Lyman GH, Khorana AA et al, American Society of Clinical Oncology Clinical Practice (2013) Venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 31:2189–2204
17.
Zurück zum Zitat Mantha S, Miao Y (2015) Safe and effective use of rivaroxaban for treatment of cancer-associated venous thromboembolic disease: a quality improvement initiative. Blood 126(23):431 Mantha S, Miao Y (2015) Safe and effective use of rivaroxaban for treatment of cancer-associated venous thromboembolic disease: a quality improvement initiative. Blood 126(23):431
18.
Zurück zum Zitat Pabinger I, Alt-Epping B (2011) Venous thrombembolism in tumour patients. Hämostaseologie 31:281–290CrossRefPubMed Pabinger I, Alt-Epping B (2011) Venous thrombembolism in tumour patients. Hämostaseologie 31:281–290CrossRefPubMed
19.
Zurück zum Zitat Prandoni P, Lensing AW (2002). Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 100:3484–3488CrossRefPubMed Prandoni P, Lensing AW (2002). Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 100:3484–3488CrossRefPubMed
20.
Zurück zum Zitat Sherwood MW, Douketis JD (2014) Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF). Circulation 129:1850–1859CrossRefPubMedPubMedCentral Sherwood MW, Douketis JD (2014) Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF). Circulation 129:1850–1859CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Short NJ, Connors JM (2014) New oral anticoagulants and the cancer patient. Oncologist 19(1):82–93CrossRefPubMed Short NJ, Connors JM (2014) New oral anticoagulants and the cancer patient. Oncologist 19(1):82–93CrossRefPubMed
23.
Zurück zum Zitat Siegal DM, Yudin J (2012) Periprocedural heparin bridging in patients receiving vitamin K antagonists, systemic review and meta-analysis of bleeding and thromboembolic rates. Circulation 126:1630–1639CrossRefPubMed Siegal DM, Yudin J (2012) Periprocedural heparin bridging in patients receiving vitamin K antagonists, systemic review and meta-analysis of bleeding and thromboembolic rates. Circulation 126:1630–1639CrossRefPubMed
24.
Zurück zum Zitat Spyropoulos AC, Douketis JD (2012) How I treat anticoagulated patients undergoing an elective procedure or surgery. Blood 120:2954–2962CrossRefPubMed Spyropoulos AC, Douketis JD (2012) How I treat anticoagulated patients undergoing an elective procedure or surgery. Blood 120:2954–2962CrossRefPubMed
25.
Zurück zum Zitat Stangier DJ, Stähle H (2008) Pharmacokinetics and pharmacodynamics of the direct oral thrombin inhibitor dabigatran in healthy elderly subjects. Clin Pharmacokinet 47:47–59CrossRefPubMed Stangier DJ, Stähle H (2008) Pharmacokinetics and pharmacodynamics of the direct oral thrombin inhibitor dabigatran in healthy elderly subjects. Clin Pharmacokinet 47:47–59CrossRefPubMed
26.
Zurück zum Zitat Tripodi A (2013) The laboratory and the direct oral anticoagulants. Blood 121:4032–4035 Tripodi A (2013) The laboratory and the direct oral anticoagulants. Blood 121:4032–4035
27.
Zurück zum Zitat Upreti VV, Wang J (2013) Effect of extremes of body weight on the pharmacokinetics, pharmacodynamics, safety and tolerability of apixaban in healthy subjects. Br J Clin Pharmacol 76:908–916CrossRefPubMedPubMedCentral Upreti VV, Wang J (2013) Effect of extremes of body weight on the pharmacokinetics, pharmacodynamics, safety and tolerability of apixaban in healthy subjects. Br J Clin Pharmacol 76:908–916CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Van der Hulle T, den Exter PL (2014) Meta-analysis of the efficacy and safety of new oral anticoagulants in patients with cancer-associated acute venous thromboembolism. J Thromb Haemost 12:1116–1120CrossRefPubMed Van der Hulle T, den Exter PL (2014) Meta-analysis of the efficacy and safety of new oral anticoagulants in patients with cancer-associated acute venous thromboembolism. J Thromb Haemost 12:1116–1120CrossRefPubMed
29.
Zurück zum Zitat Vedovati MC, Germini F (2015) Direct oral anticoagulants in patients with venous thromboembolism and cancer: a systematic review and meta-analysis. Chest 147:475–483CrossRefPubMed Vedovati MC, Germini F (2015) Direct oral anticoagulants in patients with venous thromboembolism and cancer: a systematic review and meta-analysis. Chest 147:475–483CrossRefPubMed
Metadaten
Titel
Direkte orale Antikoagulanzien bei Tumorpatienten — eine Alternative?
verfasst von
Dr. Frank Breywisch
Publikationsdatum
26.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
best practice onkologie / Ausgabe 5/2016
Print ISSN: 0946-4565
Elektronische ISSN: 1862-8559
DOI
https://doi.org/10.1007/s11654-016-0585-2

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