A tablet a day may help prevent deadly blood clots in cancer patients, notes new research

Taking a tablet every day may help to prevent cancer patients from potentially lethal blood clots, according to new research from the University of Warwick.

Cancer patients are at an increased risk of developing blood clots, such as deep vein thrombosis (DVT) or venous thromboembolism (VTE), with current guidelines recommending that anticoagulant injections are administered as a treatment and preventative measure.

However, in the research, led by Professor Annie Young of Warwick Medical School — ‘select-d’, it was found that using the oral drug rivaroxaban (Xarelto) daily could significantly reduce the risk of venous thromboembolism recurrence among patients with cancer and VTE.

“Clinicians were already adopting the oral drug into practice for non-cancer patients and now they have data from this study to indicate that this form of treatment is an alternative option for many cancer patients who have a clot,” Young said.

The trial enrolled 406 patients who had cancer and VTE, of whom 69% were receiving cancer treatment (typically chemotherapy) at the time of their VTE. Half were randomly assigned to receive low-molecular-weight heparin (dalteparin) and half were given the oral drug rivaroxaban. After six months of treatment, the VTE recurrence rate was four percent among those taking the tablet and 11 percent in those receiving dalteparin.

The results for secondary outcomes were mixed. In patients receiving rivaroxaban, there were around the same percentage of major bleeding events (6%) as those receiving dalteparin (4%) but a marked and significant increase in clinically relevant non-major bleeds (13%) with rivaroxaban compared to those having low molecular weight heparin (4%). The reason for increased bleeding is not known, it may be because rivaroxaban is more ‘potent’.

Young added: “We now need to be sitting down with each one of our cancer patients with VTE, discussing their preference alongside looking at all their clinical details including whether the cancer lesion is still there, what other medications are being taken and what other conditions the patient has so that we can choose the optimal VTE treatment for each patient.”