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Hematology (all articles)

RCT | Noninferiority shown between DOACs and LMWH for recurrent VTE prevention in cancer patients

5 Jun, 2023 | 13:50h | UTC

Summary: This unblinded, pragmatic, noninferiority randomized clinical trial aimed to assess the efficacy of direct oral anticoagulants (DOACs) against low-molecular-weight heparin (LMWH) in preventing recurrent venous thromboembolism (VTE) in patients with cancer. The study included 671 patients from 67 oncology centers, with a new clinical or radiological diagnosis of VTE.

Participants were randomly assigned to receive either a DOAC or LMWH for 6 months, and treating physicians selected and prescribed the drugs based on considerations like availability and drug-drug interactions. The primary outcome was the rate of recurrent VTE at 6 months. Findings revealed that the DOAC group had a recurrent VTE rate of 6.1% as compared to 8.8% in the LMWH group, showing noninferiority. Both groups had statistically similar rates of major bleeding and severe adverse events.

This pragmatic study included patients with advanced cancer and brain metastases, impaired performance status, and reduced liver or kidney function, making it more representative of routine oncology practice. Moreover, patient adherence to DOAC treatment was significantly higher than to LMWH. Nevertheless, the study had limitations, including the lack of blinding and underrepresentation of certain racial and ethnic groups.

In conclusion, this trial suggests that DOACs were noninferior to LMWH for preventing recurrent VTE in patients with cancer over a 6-month follow-up period, supporting the use of DOACs in this population for VTE prevention. Further research is needed to confirm these results and investigate long-term outcomes.

Article: Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin and Recurrent VTE in Patients With Cancer: A Randomized Clinical Trial – JAMA (free for a limited period)

See also: Visual abstract

 

Commentary on Twitter

 


Review | Prevention of venous thromboembolism in patients with cancer

5 Jun, 2023 | 13:48h | UTC

Prevention of venous thromboembolism in patients with cancer – The BMJ

 


M-A | Hypoxia-inducible factor stabilizers’ effects on lab parameters and outcomes in CKD patients with renal anemia

5 Jun, 2023 | 13:00h | UTC

The impacts of hypoxia-inducible factor stabilizers on laboratory parameters and clinical outcomes in chronic kidney disease patients with renal anemia: a systematic review and meta-analysis – Clinical Kidney Journal

 


ASH 2023 Guidelines for management of venous thromboembolism | Thrombophilia testing

1 Jun, 2023 | 12:22h | UTC

American Society of Hematology 2023 Guidelines for Management of Venous Thromboembolism: Thrombophilia Testing – Blood Advances

 


Cardiac toxicities in multiple myeloma: an updated and a deeper look into the effect of different medications and novel therapies

1 Jun, 2023 | 11:48h | UTC

Cardiac toxicities in multiple myeloma: an updated and a deeper look into the effect of different medications and novel therapies – Blood Cancer Journal

 


RCT | Prophylactic platelet transfusion reduces CVC-related bleeding in patients with platelets 10-50 K/mm³

31 May, 2023 | 14:20h | UTC

Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Research from Amsterdam UMC shows that the bottom has been reached in restrictive blood transfusion policy – Amsterdam University Medical Centers

 

Commentary on Twitter

 


RCT | Early initiation of DOACs not statistically superior to later use in atrial fibrillation-related stroke

31 May, 2023 | 14:17h | UTC

Early versus Later Anticoagulation for Stroke with Atrial Fibrillation – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

ELAN: Early DOACs Safe, May Help After Ischemic Stroke in AF Patients – TCTMD

Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischemic Stroke Patients With Atrial Fibrillation – ELAN – American College of Cardiology

 

Commentary on Twitter

 


Review | How to approach acute thrombosis and thrombocytopenia

31 May, 2023 | 14:03h | UTC

How to approach acute thrombosis and thrombocytopenia – Clinical Medicine Journal

 


Current guidelines for perioperative management and transfusion decisions in sickle cell patients

30 May, 2023 | 11:57h | UTC

Current Evidence and Rationale to Guide Perioperative Management, Including Transfusion Decisions, in Patients With Sickle Cell Disease – Anesthesia & Analgesia

 


Cohort Study | Amiodarone linked to higher bleeding risk vs. flecainide or sotalol in atrial fibrillation patients on anticoagulants

30 May, 2023 | 12:01h | UTC

Risk for Bleeding-Related Hospitalizations During Use of Amiodarone With Apixaban or Rivaroxaban in Patients With Atrial Fibrillation: A Retrospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

News Release: Amiodarone used with anticoagulant therapy linked to more bleeding-related hospitalizations than flecainide or sotalol – American College of Physicians

Commentary: Amiodarone increases bleeding compared with flecainide or sotalol in patients on anticoagulant therapy – ACP Internist

 

Commentary on Twitter

 


Guideline | Investigation and management of acute transfusion reactions

29 May, 2023 | 11:02h | UTC

Guideline on the investigation and management of acute transfusion reactions – British Journal of Haematology

 


RCT | Apixaban fails to match warfarin in preventing valve thrombosis in On-X mechanical heart valve patients

22 May, 2023 | 13:44h | UTC

Apixaban or Warfarin in Patients with an On-X Mechanical Aortic Valve – NEJM Evidence

Commentary: Apixaban or Warfarin in Patients With On-X Mechanical Aortic Valve – American College of Cardiology

 

Commentary on Twitter

 


RCT | Ruxolitinib achieves greater molecular response and EFS in hydroxycarbamide-resistant Polycythemia Vera

22 May, 2023 | 13:35h | UTC

Ruxolitinib Versus Best Available Therapy for Polycythemia Vera Intolerant or Resistant to Hydroxycarbamide in a Randomized Trial – Journal of Clinical Oncology

Commentary: Ruxolitinib Appears to Yields Superior Responses in Polycythemia Vera Subtype – Cancer Network

 


RCT | Superior progression-free survival with Venetoclax-based regimens in first-line CLL treatment

22 May, 2023 | 13:32h | UTC

First-Line Venetoclax Combinations in Chronic Lymphocytic Leukemia – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: First-Line Venetoclax Combinations vs Chemoimmunotherapy in Fit Patients With CLL – The ASCO Post

 

Commentary on Twitter

 


RCT | The addition of Quizartinib to chemotherapy improves overall survival vs placebo in FLT3-ITD-positive AML patients

18 May, 2023 | 13:40h | UTC

Quizartinib plus chemotherapy in newly diagnosed patients with FLT3-internal-tandem-duplication-positive acute myeloid leukaemia (QuANTUM-First): a randomised, double-blind, placebo-controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)

 

Commentary on Twitter (thread – click for more)

 


Phase 2 RCT | Ropeginterferon shows better results in hematocrit control vs phlebotomy alone in patients withr polycythemia vera

18 May, 2023 | 13:37h | UTC

Ropeginterferon versus Standard Therapy for Low-Risk Patients with Polycythemia Vera – NEJM Evidence

 


RCT | Motixafortide and G-CSF to mobilize hematopoietic stem cells for autologous transplantation in multiple myeloma

16 May, 2023 | 14:48h | UTC

Motixafortide and G-CSF to mobilize hematopoietic stem cells for autologous transplantation in multiple myeloma: a randomized phase 3 trial – Nature Medicine

News Release: Investigational drug may improve stem cell transplantation for multiple myeloma patients – Washington University in St. Louis

 

Commentary on Twitter

 


RCT | Bortezomib-Dexamethasone, Rituximab, and Cyclophosphamide for Waldenström’s Macroglobulinemia

16 May, 2023 | 14:24h | UTC

Bortezomib-Dexamethasone, Rituximab, and Cyclophosphamide as First-Line Treatment for Waldenström’s Macroglobulinemia: A Prospectively Randomized Trial of the European Consortium for Waldenström’s Macroglobulinemia – Journal of Clinical Oncology (link to abstract – $ for full-text)

Commentary: Addition of Bortezomib to First-Line Dexamethasone, Rituximab, and Cyclophosphamide for Waldenström’s Macroglobulinemia – The ASCO Post

 


RCT | Rivaroxaban doesn’t reduce thrombotic events, hospitalization, or death in outpatients with COVID-19

15 May, 2023 | 13:19h | UTC

Summary: The PREVENT-HD trial, a double-blind, placebo-controlled randomized study, was conducted to evaluate the effectiveness of prophylactic anticoagulation in reducing venous and arterial thrombosis, hospitalization, and death in nonhospitalized patients with symptomatic COVID-19 and at least one thrombosis risk factor. The trial took place between August 2020 and April 2022 across 14 US integrated healthcare delivery networks, with 1,284 patients enrolled and randomly assigned to receive either 10 mg of oral rivaroxaban or placebo daily for 35 days.

However, the study was terminated prematurely due to enrollment challenges and lower-than-expected event rates. The primary efficacy outcome, a composite of various hazardous events, occurred in 3.4% of the rivaroxaban group and 3.0% of the placebo group, with no significant difference between the two groups (hazard ratio, 1.16 [95% CI, 0.63–2.15]; P=0.63). No critical-site or fatal bleeding was observed, and only one patient in the rivaroxaban group experienced a major bleed.

In conclusion, rivaroxaban prescribed for 35 days in nonhospitalized patients with symptomatic COVID-19 at risk for thrombosis does not appear to reduce the composite end point of venous and arterial thrombotic events, hospitalization, and death. The study’s premature termination and lower-than-expected event rates may limit the generalizability of these findings.

Article: Rivaroxaban for Prevention of Thrombotic Events, Hospitalization, and Death in Outpatients With COVID-19: A Randomized Clinical Trial – Circulation

 

Commentary on Twitter

 


Therapeutic plasma exchange: Core curriculum 2023

15 May, 2023 | 13:14h | UTC

Therapeutic Plasma Exchange: Core Curriculum 2023 – American Journal of Kidney Diseases

 

Commentary on Twitter

 


Brief Review | Coagulation support during perioperative bleeding management

15 May, 2023 | 13:01h | UTC

Coagulation support during perioperative bleeding management – Intensive Care Medicine

 

Commentary on Twitter

 


Review | Treatment of amyloidosis: present and future

12 May, 2023 | 13:22h | UTC

Treatment of amyloidosis: present and future – European Heart Journal Supplements

See all articles in the series here

 


Podcast | Hypercoagulable work-up

11 May, 2023 | 11:41h | UTC

#391 Hypercoagulable Work-Up with Dr. Jean Connors – The Curbsiders

 


Consensus Paper | Antithrombotic treatment strategies in patients with established coronary atherosclerotic disease

10 May, 2023 | 15:51h | UTC

Antithrombotic treatment strategies in patients with established coronary atherosclerotic disease: 2022 joint clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI), Association for Acute CardioVascular Care (ACVC) and European Association of Preventive Cardiology (EAPC) – European Heart Journal – Cardiovascular Pharmacotherapy

 


RCT | Ibrutinib plus rituximab improve CLL PFS vs chemoimmunotherapy, but increased unexplained/cardiac deaths

8 May, 2023 | 13:00h | UTC

Ibrutinib and rituximab versus fludarabine, cyclophosphamide, and rituximab for patients with previously untreated chronic lymphocytic leukaemia (FLAIR): interim analysis of a multicentre, open-label, randomised, phase 3 trial – The Lancet Oncology

 


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