Use of low-molecular-weight heparin for the treatment of venous thromboembolism in patients with cancer: A review of the literature

Document Type

Article

Publication Title

Journal of Pharmacy Technology

Abstract

Objective: To evaluate the literature on use of low-molecular-weight heparin (LMWH) for the treatment of venous thromboembolism (VTE) in patients with cancer for the first 3-6 months of anticoagulant therapy. Data Sources: A preliminary literature search of PubMed (1966-May 2009) was performed, using the MeSH database when possible, with the terms venous thromboembolism, venous thrombosis, pulmonary embolism, neoplasm, vitamin K antagonist, and low-molecular-weight heparin. Bibliographies of all articles retrieved were also reviewed. Study Selection and Data Extraction: All studies published in English with data describing the safety and/or efficacy of LMWH in subjects with cancer for the first 3-6 months of anticoagulant therapy for VTE were included. Data Synthesis: Five studies that met the above criteria were identified. When compared with vitamin K antagonists, LMWH therapy decreased recurrent VTE in subjects with cancer. Many of these studies had important limitations, including open-label design, relatively short duration, ineffective LMWH dosing, and small sample size. Conclusions: The studies analyzed support the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines' recommendation for the use of LMWH for the first 3-6 months of anticoagulant therapy for VTE in patients with cancer. Specifically, in clinical trials, tinzaparin and dalteparin have demonstrated increased efficacy compared with vitamin K antagonists.

First Page

244

Last Page

249

DOI

10.1177/875512250902500405

Publication Date

1-1-2009

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