Prophylactic Warfarin Doesn't Cut Cancer Patient Thromboses
Other treatments should be explored for cancer patients with central venous catheters
FRIDAY, Feb. 13 (HealthDay News) -- Treating cancer patients who have central venous catheters with prophylactic warfarin does not reduce the risk of symptomatic catheter-related or other thromboses, according to a report published in the Feb. 14 issue of The Lancet.
Annie M. Young, of the University of Birmingham in the United Kingdom, and colleagues conducted a study of 812 adult cancer patients who had a central venous catheter in order to receive chemotherapy and assigned 404 patients to no warfarin, and 408 to warfarin, including 324 patients on fixed-dose warfarin and 84 on dose-adjusted warfarin.
The rate of catheter-related thromboses was identical in both groups, at 6 percent of the total, the investigators found. There were few excess bleeding events, although more events recorded occurred in the warfarin groups than in the no warfarin group, the researchers report. They also found that compared with fixed-dose warfarin, dose-adjusted warfarin was more effective at preventing catheter-related thromboses.
"The rate of symptomatic catheter-related thromboses reported in clinical trials has fallen substantially over the past decade. The improvements in catheter technology, placement and aftercare are contributing to this reduction," the authors write. "When any benefit of thromboprophylaxis was balanced against the risk of major bleeding, the combined outcome showed no advantage with the use of any dose of warfarin. These findings only add to the assertion that the time has come to move on from warfarin for thromboprophylaxis in patients with cancer."