Nonvitamin K Antagonist Oral Anticoagulant in Patients With Venous Thromboembolism and Polycythemia Vera or Essential Thrombocythemia: A Cohort Study.

Abstract

ABSTRACT:

Thrombosis is the most common adverse event in patients with polycythemia vera (PV) and essential thrombocythemia (ET). Little is known about the use of nonvitamin K antagonist oral anticoagulants (NOACs) in patients with myeloproliferative neoplasms. We sought to evaluate the efficacy and safety of NOAC in a cohort of patients with PV and ET, who experienced venous thromboembolism (VTE). We enrolled 48 consecutive patients with PV (70.8%) and ET [median age 67.0 (interquartile range, 58.5-72.0) years], who experienced VTE. Patients received apixaban (39.6%), rivaroxaban (33.3%), or dabigatran (27.1%). During a median follow-up of 30 (interquartile range, 20.5-41.5) months, recurrent thrombotic events and bleeding were recorded. Four thrombotic events (3.3 per 100 patient-years) were reported. Three deep vein thrombosis episodes (2.5 per 100 patient-years) were experienced by 2 patients with PV, who received apixaban (5 mg bid) and dabigatran (150 mg bid), and 1 patient with ET, who received dabigatran (150 mg bid). One ischemic stroke occurred in a patient with PV on rivaroxaban (20 mg/d). There was 1 major bleeding (0.8 per 100 patient-years) in a patient with ET on dabigatran (150 mg bid) and 3 clinically relevant nonmajor bleeding (2.5 per 100 patient-years): 2 on rivaroxaban (20 mg/d) and 1 on apixaban (5 mg bid). We did not observe significant differences related to the type of NOAC. Three deaths (2.5 per 100 patient-years) unrelated to either VTE or bleeding were recorded. This study shows that NOACs may be effective and safe as secondary prevention of VTE in patients with myeloproliferative neoplasms.

• Authors: Anna Weronska, Elżbieta Papuga-Szela, Elzbieta Broniatowska, Anetta Undas
• Journal: Journal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 78 Issue 5 Pg. e743-e748 (11 01 2021) ISSN: 1533-4023 [Electronic] United States
• PMID: 34321399 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Antithrombins
• Factor Xa Inhibitors
• Pyrazoles
• Pyridones
• apixaban
• Rivaroxaban
• Dabigatran

Topics

• Administration, Oral
• Aged
• Antithrombins (administration & dosage, adverse effects)
• Dabigatran (administration & dosage, adverse effects)
• Factor Xa Inhibitors (administration & dosage, adverse effects)
• Female
• Hemorrhage (chemically induced)
• Humans
• Male
• Middle Aged
• Polycythemia Vera (blood, diagnosis, drug therapy)
• Pyrazoles (administration & dosage, adverse effects)
• Pyridones (administration & dosage, adverse effects)
• Recurrence
• Risk Assessment
• Risk Factors
• Rivaroxaban (administration & dosage, adverse effects)
• Secondary Prevention
• Thrombocythemia, Essential (blood, diagnosis, drug therapy)
• Time Factors
• Treatment Outcome
• Venous Thromboembolism (blood, diagnosis, prevention & control)