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Therapeutics/Prevention
Randomised controlled trial
Low-molecular-weight heparin for the treatment of acute venous thromboembolism in patients with active cancer
  1. Marcello Di Nisio1,
  2. Anne W S Rutjes2,3
  1. 1University G D'Annunzio, Chieti, Italy;
  2. 2Centre for Systematic Reviews at the Fondazione Università G D'Annunzio, Chieti, Italy;
  3. 3Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  1. Correspondence to : Dr Marcello Di Nisio, University G D'Annunzio, via dei Vestini, Chieti 66100, Italy; mdinisio{at}unich.it

https://doi.org/10.1136/ebmed-2015-110305

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    Commentary on: Lee AY, Kamphuisen PW, Meyer G, et al., CATCH Investigators. Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: a randomized clinical trial. JAMA 2015;314:677–86.OpenUrlCrossRefPubMed

    Context

    The management of acute venous thromboembolism (VTE) in patients with active cancer is challenging. In the landmark CLOT study,1 low-molecular-weight heparin (LMWH) halved the incidence of recurrent VTE compared to vitamin K antagonists (VKAs) with similar rates of major bleeding. These observations were confirmed in additional smaller studies, which, together with the more stable pharmacokinetics of LMWH, have led to the recommendation of LMWH over VKAs.2 ,3 Notwithstanding the favourable profile of LMWH, VKAs remain widely used worldwide. In this context, the results of the CATCH study were eagerly awaited.

    Methods

    The CATCH study was a two-arm parallel design, randomised, open-label study …

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    Footnotes

    • Contributors MDN and AWSR were responsible for drafting, critical revision for important intellectual content and final approval of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.