利伐沙班防治恶性肿瘤相关血栓的研究进展

Research Progress of Rivaroxaban in the Prevention and Treatment of Cancer-related Thrombosis

利伐沙班是直接的Ⅹa因子抑制剂,用于预防和治疗静脉血栓栓塞症(venousthromboembolism,VTE)。恶性肿瘤相关血栓(cancer-related thrombosis,CAT)发病率较高,由于CAT的高复发风险,肿瘤患者通常需要延长抗凝疗程,但同时又会增加出血风险。低分子肝素(low molecular weight heparin,LMWH)作为防治CAT的主要药物在患者长期应用中依从性较差,利伐沙班逐渐成为CAT患者抗凝防治中很有竞争力的选择。从临床研究上看,利伐沙班治疗CAT的有效性和安全性较好,在长期预防过程中患者也有所获益,但在消化道肿瘤伴CAT治疗中出血风险较高,临床广泛使用还需要相关研究进一步验证。本文就CAT的疾病特点和利伐沙班用于预防和治疗CAT的临床研究等方面进行综述。

Rivaroxaban is a direct inhibitor of factor Xa for the prevention and treatment of venous thromboembolism. The incidence of cancer-related thrombosis(CAT) is relatively high. Due to the high risk of recurrence of CAT, tumor patients usually need to extend the anticoagulation course, while increasing the risk of bleeding. Low molecular weight heparin, as the main drug for CAT prevention and treatment, has poor compliance in patients with long term application, and rivaroxaban has gradually become a very competitive choice for anticoagulation control in patients with CAT. From the perspective of clinical studies, the effectiveness and safety of rivaroxaban in the treatment of CAT is affirmative, patients also benefit from long-term prevention. However, the risk of bleeding is higher in the treatment of gastrointestinal tumors with CAT, and the widespread clinical use needs further verification by relevant studies. This article reviewed the disease characteristics of CAT and the clinical research of rivaroxaban in the prevention and treatment of CAT.