Study supports use of LMWH over warfarin for treatment of acute VTE in patients with active cancer

the Oncology Nurse Advisor take:

The use of the low molecular-weight heparin (LMWH) tinzaparin daily for 6 months compared with warfarin was associated with a lower rate of clinically relevant nonmajor bleeding among patients with active cancer and acute symptomatic venous thromboembolism (VTE), according to a new study published in JAMA; however, there was no significant difference in reducing recurrent VTE, overall death, or major bleeding.

Previous data has shown that LMWH is preferred over warfarin for the treatment of acute VTE in patients with active cancer, but that recommendation is largely based on results of a single trial. Therefore, researchers sought to compare the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic VTE in patients with active cancer.

For the study, researchers enrolled 900 adult patients with active cancer from 164 centers in 5 continents and randomly assigned them 1:1 to receive tinzaparin 175 IU/kg once daily for 6 months vs conventional therapy with tinzaparin 175 IU/kg once daily for 5 to 10 days followed by warfarin dose-adjusted to an INR of 2.0-3.0 for 6 months.

The findings suggest that further studies are warranted to evaluate efficacy outcomes among patients with active cancer at higher risk for recurrent VTE.