Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study
Javier Trujillo‐Santos, Dominique Farge, José María Pedrajas, Covadonga Gómez‐Cuervo, Aitor Ballaz, Andrei Braester, Isabelle Mahé, Aurora Villalobos, José Antonio Porras, Manuel Monréal, M.D. Adarraga, Jesús Aibar, M.A. Aibar, Cristina Amado, J.I. Arcelus, A Asuero, Raquel Barba, C. Barbagelata, M. Barrón, B. Barrón‐Andrés, Á. Blanco-Molina, Enrique Ramón Botella, A.M. Camón, I. Casado, Joaquín Castro, Marcela Araújo Castro, Leyre Chasco, Juan Criado, Cristina de Ancos, J. del Toro, Pablo Demelo‐Rodríguez, A.M. Díaz-Brasero, J.A. Díaz‐Peromingo, MV Di Campli, Álvaro Dubois-Silva, J.C. Escribano, F. Espósito, C. Falgá, Ana Isabel Farfán‐Sedano, Carmen Fernández‐Capitán, J L Fernández-Reyes, MA Fidalgo, Katia Flores, Carme Font, Llorenç Font, Iria Francisco, Cristina Gabara, Francisco Galeano‐Valle, M.A. García, F. García‐Bragado, Marta García de Herreros, Rocío García de la Garza, Catarino García-Díaz, R. García-Hernáez, Aránzazu García‐Raso, Aída Gil‐Díaz, M. Giménez-Suau, E Grau, L. Guirado, J Gutiérrez, L Hernández‐Blasco, E. Rocha Hernando, Luis Jara‐Palomares, M.J. Jaras, David Jiménez, Ruth Jiménez Castuera, Carmen Jiménez-Alfaro, M.D. Joya, S. Láinez-Justo, Amaya Delgado Latorre, Jorge Roberto Perrout de Lima, Pilar Llamas, JL Lobo, Luciano López-Jiménez, Patricia López-Miguel, J J López-Núñez, Raquel López-Reyes, J.B. López‐Sáez, A. Lorenzo, Olga Madridano, Ana M. Maestre, P.J. Marchena, F. Martín‐Martos, Diego Martínez‐Urbistondo, C Mella, MI Mercado, Jorge Moisés, M.V. Morales, A Muñoz‐Blanco, N Muñoz‐Rivas, M.S. Navas, J.A. Nieto, E Nofuentes‐Pérez, MJ Núñez‐Fernández, Berta Obispo, M. Olid, M.C. Olivares, J.L. Orcastegui, Jeisson Osorio, S. Otálora
Abstract
Background: Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a leading cause of morbidity and death. Objectives: The objective of the RIETECAT study was to compare the long-term effectiveness and safety of enoxaparin versus dalteparin or tinzaparin for the secondary prevention of VTE in adults with active cancer. Methods: We used the data from the multicenter, multinational RIETE registry to compare the rates of VTE recurrences, major bleeding, or death over 6 months in patients with active cancer and acute VTE using full doses of enoxaparin versus dalteparin or tinzaparin, and a multivariable Cox proportional hazard model was used to analyze the primary end point. Results: From January 2009 to June 2018, 4451 patients with active cancer received full doses of the study drugs: enoxaparin, 3526 patients; and dalteparin or tinzaparin, 925 (754 + 171) patients. There was limited difference in VTE recurrences (2.0% vs 2.5%) and mortality rate (19% vs 17%) between the enoxaparin and dalteparin or tinzaparin subgroups. However, there was a slight numerical increase in major bleeding (3.1% vs 1.9%). Propensity score matching confirmed that there were no differences in the risk for VTE recurrences (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.48-1.38), major bleeding (aHR, 1.40; 95% CI, 0.80-2.46), or death (aHR, 1.07; 95% CI, 0.88-1.30) between subgroups. Conclusions: In RIETECAT, in patients with cancer and VTE receiving full-dose enoxaparin or dalteparin or tinzaparin, no statistically significant differences were observed regarding effectiveness and safety outcomes over a 6-month period.