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  • In patients with cancer and venous thromboembolism (VTE), enoxaparin was as effective as warfarin for VTE prophylaxis and reduced fatal haemorrhage

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Therapeutics
In patients with cancer and venous thromboembolism (VTE), enoxaparin was as effective as warfarin for VTE prophylaxis and reduced fatal haemorrhage

https://doi.org/10.1136/ebm.8.3.85

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    (2002) Arch Intern Med 162, 1729. Meyer G, Marjanovic Z, Valcke J, et al.. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study.. ;. :. –35.
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 QUESTION: In patients with cancer and venous thromboembolism (VTE), is a fixed dose of subcutaneous low molecular weight (LMW) heparin better than oral warfarin for secondary prophylaxis of VTE?

    Design

    Randomised {allocation concealed*}†, blinded {outcome assessors and data analysts}†,* controlled trial with primary follow up to 3 months.

    Setting

    25 centres in France.

    Patients

    146 patients >18 years of age (mean age 66 y, 55% women) with cancer of any type and deep venous thrombosis and/or pulmonary embolism. Exclusion criteria were previous heparin induced thrombocytopenia, allergy to iodine, pregnancy, fibrinolytic treatment within 3 days, oral anticoagulant use for >5 days, treatment with full dose heparin for this episode of VTE, major pulmonary embolism with shock, life expectancy <3 months, contraindication to anticoagulants, severe hepatic failure, planned major surgery or …

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    Footnotes

    • Sources of funding: Aventis and the Délégation à la Recherche Clinique.

    • For correspondence: Dr G Meyer, Hôpital Européen Georges Pompidou, Paris, France. guy.meyer{at}hop.egp.ap-hop-paris.fr.

    • ↵* See glossary.

    • ↵† Information provided by author.