Anticoagulant effects of edoxaban in cancer and noncancer patients with venous thromboembolism

Abstract Background Edoxaban, a direct oral anticoagulant (DOAC), is a first-line treatment for venous thromboembolism (VTE) and the suppression of VTE recurrence. In patients with cancer, however, recurrent VTE after DOAC treatment may be more common than in noncancer patients. To evaluate our hypo...

Full description

Saved in:
Bibliographic Details
Main Authors: Masashi Yoshida, Kentaro Ejiri, Naoaki Matsuo, Takanori Naito, Kazuhiro Kuroda, Koji Tokioka, Kunihiko Hatanaka, Ryohei Fujimoto, Hidenaru Yamaoka, Yutaka Kajikawa, Kazuki Suruga, Hiroki Sugiyama, Tsuyoshi Miyaji, Yoshimasa Morimoto, Nobuhiro Okamura, Toshihiro Sarashina, Satoshi Akagi, Toru Miyoshi, Kazufumi Nakamura, Hiroshi Ito, Shinsuke Yuasa
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Thrombosis Journal
Subjects:
Online Access:https://doi.org/10.1186/s12959-025-00720-0
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Edoxaban, a direct oral anticoagulant (DOAC), is a first-line treatment for venous thromboembolism (VTE) and the suppression of VTE recurrence. In patients with cancer, however, recurrent VTE after DOAC treatment may be more common than in noncancer patients. To evaluate our hypothesis that the anticoagulation effect of edoxaban is lower in VTE patients with cancer than in noncancer patients. Methods This study was a prospective, multicenter, observational study including patients treated with edoxaban for VTE in Japan. The primary outcome was the difference in the prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer level at 5 h after initial edoxaban administration between the cancer and noncancer groups. An additional outcome was the longitudinal change in PT and APTT from 5 h to overnight after edoxaban administration. The incidence of adverse events was further investigated. Results PT and APTT at 5 h after initial edoxaban administration were not significantly different between the cancer (n = 84) and noncancer groups (n = 138) (e.g., log-transformed APTT 3.55 vs. 3.55, p = 0.45). However, D-dimer in the cancer groups was significantly greater than that in the noncancer groups (log-transformed 1.83 vs. 1.79, p = 0.009). PT and APTT significantly decreased from 5 h to overnight after edoxaban, but a similar pattern was observed in each group. All adverse events after edoxaban administration were also similar between patients with cancer and noncancer. Conclusion PT and APTT after edoxaban administration were similar between VTE patients with cancer and noncancer groups, suggesting that edoxaban has anticoagulation effects on cancer-associated VTE similar to those of noncancer patients. Trial registration UMIN000041973; Registration Date: 2020.10.5.
ISSN:1477-9560