Warfarin use in cancer-associated thrombosis tied to improved overall survival: Study

Based on Surveillance, Epidemiology and End Results (SEER) and Medicare linked database, the researchers identified Medicare beneficiaries (aged ≥66 years) who were: (1) diagnosed with primary gastric, colorectal, pancreatic, lung, ovarian, or brain cancer; (2) diagnosed with cancer-associated VTE; and (3) prescribed LMWH or warfarin within 30 days. Patients were matched 1:1 using exact matching for cancer stage and propensity scored matching for cancer diagnosis, age, year of VTE, and time from cancer diagnosis to index VTE. 

 A total of 9,706 patients were included and ones with solid malignancies and cancer-associated VTE were assessed for overall survival (OS) in patients who received LMWH versus warfarin.

The results were found to be:

• Warfarin was associated with a significant improvement in OS compared to LMWH (median OS, 9.8 months versus 7.2 months; HR, 0.86).

• The survival advantage was most pronounced in pancreatic (HR 0.82) and gastric cancers (HR 0.82).

• The observed differences in survival were consistent across subgroups including cancer stage, age, comorbidity burden, and year of VTE.

Beth and the team concluded that "In this population-based study, warfarin was associated with improved OS compared to LMWH for the treatment of cancer-associated VTE." However additional prospective studies with longer follow-up are warranted.

Reference:

doi:10.1111/jth.15519