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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB0949 - Treatment patterns in an unselected sample of patients with cancer associated thrombosis – data from the TROLL registry

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: Currently international guidelines recommend direct oral anticoagulants (DOACs) as first-line treatment for cancer-associated thrombosis (CAT). However, apart from clinical trials, data is scarce concerning the usage of DOACs in clinical practice in patients with CAT.

    Aims: To describe anticoagulant treatment patterns in patients diagnosed with CAT and to evaluate anticoagulant-related bleeding events.

    Methods: Patients were identified through the TROLL registry. Patients aged >18 years with active cancer and a first-time venous thromboembolism (VTE) during the period 2005 to 2020 in Østfold county, Norway were eligible for study inclusion. Outcome measures were treatment patterns of anticoagulants and anticoagulant-related bleeding events. Incidence rate and 6-and 12 months cumulative incidence of bleeding events were calculated. Participants who provided signed informed written consent and deceased patients were included. For deceased patients, consent was waived by The Regional Committee for Medical and Health Research Ethics (REK).

    Results: 842 patients were diagnosed with CAT. Median age at the time of diagnosis was 69 years (IQR 61-77 years) and 399 (47.3%) were women. The VTE events consisted of pulmonary embolism in 526 patients (62.5%) while 255 (30.3%) had deep vein thrombosis. Low-molecular-weight heparin (LMWH) was prescribed in 713 (85.8%) patients, whereas 64 (7.7%) received DOACs and 54 (6.5%) vitamin K antagonists as initial anticoagulant treatment. Prescription of DOAC, as initial treatment, increased from 3.0% to 18.0% from 2005 to 2020. Major bleeding occurred in 48 patients (5.7%) and clinically relevant non-major bleeding (CRNMB) in 59 (7.0%). Incidence rate for major bleeding was 6.9 per 100 person years (95% CI 5.2-9.2) and for CRNMB was 10.1 (95% CI 8.0 – 12.9). The 6- and 12-months cumulative incidence rate of major bleeding was 5.6 (95% CI 4.1-7.7) and 7.0 (95% CI 5.1-9.5), respectively.

    Conclusion(s): Although most patients were treated with LMWH, a gradual shift towards DOACs was observed. Overall, bleeding complications were rare.