Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Efficacy and Safety of a Doac Compared to Unfractionated Heparin and a Low Molecular Weight Heparin in the Prevention of Thromboembolism in Hematopoietic Stem Cell Transplant Recipients Publisher



Azimi S1 ; Hajifathali A2 ; Parkhideh S2 ; Salamzadeh J1 ; Rahmatikamel B3 ; Dastan F1, 4 ; Mehdizadeh M2 ; Abiyarghamsari M1, 5 ; Tavakoliardakani M1, 6
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran
  5. 5. Department of Internal Medicines, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Pharmaceutical Research Published:2024


Abstract

Background: Hematopoietic stem cell transplantation (HSCT) patients are at risk of thromboembolic events, making thromboprophylaxis crucial. Objectives: This study aimed to compare apixaban, a direct factor Xa inhibitor (DOAC), with dalteparin and unfractionated heparin for thromboprophylaxis in HSCT recipients. The safety outcome included the assessment of hemorrhagic events. Methods: In this open-label randomized clinical trial, 182 HSCT recipients were divided into three groups: Apixaban (n = 61, 2.5 mg two times a day), dalteparin (n = 59, 5000 IU daily), and unfractionated heparin (n = 62, 5000 IU twice daily). These anticoagulant regimens were administered after central vein catheterization and during hospitalization. The primary clinical outcome was the risk of thrombosis, and the secondary outcome was the rate of bleeding. Relevant laboratory results were analyzed using appropriate statistical tests. Results: Among the 61 patients in the apixaban group, six experienced thrombosis (9.83%), with four (6.65%) of them on anticoagulants. In the dalteparin group, three patients (5%) developed thrombosis, two of whom (3.38%) were on anticoagulants. In the heparin group, all four thrombosis cases (6.4%) occurred in patients on anticoagulants (P = 0.543 overall and P = 0.776 in anticoagulant users). Only two cases of bleeding were reported (1.09% overall), one in the dalteparin group (1.69%) and the other in the apixaban group (1.63%). Conclusions: Apixaban, dalteparin, and heparin demonstrated similar effectiveness in preventing thromboembolism in HSCT recipients. Furthermore, the comparison of bleeding rates across the study groups did not reveal significant differences. Larger studies with higher event rates may yield more precise conclusions. © 2024, Azimi et al.
Related Docs
1. Direct Oral Anticoagulants for Treatment of Venous Thrombosis: Illustrated Review of Appropriate Use, Research and Practice in Thrombosis and Haemostasis (2024)
2. When Direct Oral Anticoagulants Should Not Be Standard Treatment: Jacc State-Of-The-Art Review, Journal of the American College of Cardiology (2024)
3. Optimizing Antithrombotic Therapy in Patients With Coexisting Cardiovascular and Gastrointestinal Disease, Nature Reviews Cardiology (2024)
4. Efficacy and Safety Considerations With Dose-Reduced Direct Oral Anticoagulants: A Review, JAMA Cardiology (2022)
Experts (# of related papers)
Azita Hajhossein Talasaz (4)