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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB0945 - Effect of drug interactions with apixaban on clinical outcomes in cancer patients with venous thromboembolism

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: It is unclear how drug-interaction with apixaban influence recurrent VTE and bleedings in cancer patients.

    Aims: To investigate how drugs with moderate or unknown interaction potential with apixaban influenced recurrent venous thrombosis and bleedings.

    Methods: A post-hoc analysis of a single-arm interventional clinical trial on apixaban treatment of cancer patients with venous thromboembolism (VTE). 298 patients were divided into groups based on whether they used no interacting drugs (controls, n=74), drugs increasing bleeding risk (n=55), drugs increasing thrombosis risk (n=8), or both (n=161). Odds ratios (OR) were calculated for recurrent VTE, clinically relevant non-major bleeding (CRNMB), and major bleeding during the 36-month follow-up.

    Results: The patients took a median of 13 different drugs over the study period. 67% of the patients used drugs expected to both increase bleeding and thrombosis. The use of fluconazole appeared associated with CRNMB (OR 3.6, 95% confidence interval (CI) 0.99-13), but not with major bleeding (OR 0.56, 95% CI 0.06 - 4.8). Non-steroid anti-inflammatory drugs were not associated with CRNMB (OR 1.0, 95% CI 0.25-4.1) or major bleedings (OR 0.72, 95% CI 0.05 - 3.4). Use of antiplatelet therapy was not associated with CRNMB (OR 0.75, 95% CI, 0.22 - 2.58) or major bleeding (OR 0.2, 95% CI, 0.02-1.6). There were no major bleedings in 23 patients using aprepitant nor in the 10 patients taking macrolides. We found no association between drugs and recurrent VTE, except that there were no recurrent VTE in 19 patients using bevacizumab.

    Conclusion(s): The cancer patients used many drugs that can interact with apixaban, but none of the drugs influenced clinical outcomes, except that fluconazole may increase the risk of CRNMB.