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Article Dans Une Revue Thrombosis Research Année : 2015

Fondaparinux in the initial and long-term treatment of venous thromboembolism

Raffaele Pesavento
  • Fonction : Auteur
Maria Amitrano
  • Fonction : Auteur
Javier Trujillo-Santos
  • Fonction : Auteur
Pierpaolo Di Micco
  • Fonction : Auteur
Sara Mangiacapra
  • Fonction : Auteur
Luciano López-Jiménez
  • Fonction : Auteur
Conxita Falgá
  • Fonction : Auteur
Fernando García-Bragado
  • Fonction : Auteur
Chiara Piovella
  • Fonction : Auteur
Paolo Prandoni
  • Fonction : Auteur
Manuel Monreal
  • Fonction : Auteur
  • PersonId : 928439
Riete Investigators
  • Fonction : Auteur

Résumé

BACKGROUND: Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice. METHODS: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer. RESULTS: Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05). CONCLUSIONS: An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients.
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Dates et versions

hal-01944577 , version 1 (04-12-2018)

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Raffaele Pesavento, Maria Amitrano, Javier Trujillo-Santos, Pierpaolo Di Micco, Sara Mangiacapra, et al.. Fondaparinux in the initial and long-term treatment of venous thromboembolism. Thrombosis Research, 2015, 135 (2), pp.311-317. ⟨10.1016/j.thromres.2014.11.032⟩. ⟨hal-01944577⟩
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