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Volume 45, Issue 17, Pages 2984-2991 (November 2009)


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What is the impact of antithrombotic therapy and risk factors on the frequency of thrombovascular events in patients with metastatic breast cancer receiving epoetin beta?

Matti AaproaCorresponding Author Informationemail address, Agustí Barnadasb, Robert C. Leonardc, Maurizio Marangolod, Michael Untche, Lidia Ukarmafemail address, Hans-Ulrich Burgerf, Armin Scherhagfg, Bruno Osterwalderf

Received 18 September 2008; received in revised form 5 June 2009; accepted 26 June 2009. published online 31 July 2009.

Abstract 

Purpose, patients and methods

This retrospective analysis of the BRAVE study evaluated the impact of baseline risk factors and antithrombotic therapy on the risk of thrombovascular events (TVEs) in patients receiving epoetin compared to patients not receiving epoetin.

Results

Baseline risk factors have a significant impact on TVE risk under epoetin therapy. More than 2 risk factors increased the risk of TVEs in patients receiving epoetin (hazard ratio [HR] 2.89, confidence interval [CI] 1.04–8.02, p value [p]=0.04). In patients on epoetin without antithrombotic therapy, the risk for TVEs was higher (HR 4.11, CI 1.37–12.4, p=0.01) compared to those who received antithrombotics (HR 1.37, CI 0.59–3.18, p=0.45).

Conclusions

Our analysis has identified several risk factors which may impact the risk of TVEs under epoetin therapy. These data suggest that antithrombotic therapy may have the potential to reduce the risk of TVEs under epoetin therapy. These findings are hypothesis-generating and need to be confirmed in a prospective, randomised study.

a Institut Multidisciplinaire d’Oncologie, Clinique de Genolier, CH-1272 Genolier, Switzerland

b Hospital de Sant Pau, Barcelona, Spain

c Cancer Services and Clinical Haematology, Imperial College, Charing Cross Hospital, London, UK

d Divisione Oncologia, Ospedale Provinciale Sta Maria delle Croci, Ravenna, Italy

e Helios Klinikum, Berlin Buch, Germany

f Hoffmann-La Roche Ltd., Basel, Switzerland

g I. Medical Clinic, University Hospital Mannheim, University of Heidelberg, Germany

Corresponding Author InformationCorresponding author: Tel.: +41 (22) 366 91 06; fax: +41 (22) 366 91 31.

PII: S0959-8049(09)00512-7

doi:10.1016/j.ejca.2009.06.031


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