Available evidence for direct oral anticoagulant thromboprophylaxis in multiple myeloma*
| Trial . | Study design . | Thromboprophylaxis . | Line of MM therapy . | VTE . | Bleeding . |
|---|---|---|---|---|---|
| Louzada et al (2021)15 (interim analysis) | Randomized control trial | Aspirin 81 mg daily (n = 17) Rivaroxaban 10 mg daily (n = 17) | 8 first-line, 26 relapsed-refractory | Aspirin 1; rivaroxaban 0 | Aspirin: 0 MB, 1 CRNMB Rivaroxaban: 0 MB, 0 CRNMB |
| Sayar et al (2022)16 | Prospective, single arm† | Aspirin (n = 47) Apixaban 2.5 mg twice daily (n = 60) Prophylactic LMWH (n = 6) Clopidogrel (n = 1) No prophylaxis (n = 33) | 28 first-line, 119 relapsed- refractory | Aspirin 1; apixaban 0; LMWH 0; clopidogrel 0; no prophylaxis 1 | Aspirin: 1 MB, 0 CRNMB Apixaban: 0 MB, 1 CRNMB LMWH 0: 0 MB, 0 CRNMB Clopidogrel: 0 MB, 0 CRNMB No prophylaxis: 0 MB, 0 CRNMB |
| Cornell et al (2019)17 | Prospective, single arm | Apixaban 2.5 mg twice daily (n = 50) | 2 first-line, 18 relapsed-refractory, 10 consolidation, 20 maintenance | No VTE | 0 MB, 3 CRNMB |
| Pegourie et al (2019)18 | Prospective, single arm | Apixaban 2.5 mg twice daily (n = 50) | 11 first-line, 93 relapsed-refractory | 2 VTE | 1 MB, 11 CRNMB |
| Piedra et al (2022)19 | Retrospective | Aspirin 81 mg daily (n = 221) Aspirin 325 mg daily (n = 2) Rivaroxaban 10 mg daily (n = 82) | 305 first-line | Aspirin 24; rivaroxaban 4 | Aspirin: 0 MB, 6 CRNMB Rivaroxaban: 0 MB, 1 CRNMB |
| Storrar et al (2018)20 | Retrospective | Apixaban 2.5 mg twice daily (n = 70) | 70 first-line | No VTE | 1 MB, CRNMB NR |
| Trial . | Study design . | Thromboprophylaxis . | Line of MM therapy . | VTE . | Bleeding . |
|---|---|---|---|---|---|
| Louzada et al (2021)15 (interim analysis) | Randomized control trial | Aspirin 81 mg daily (n = 17) Rivaroxaban 10 mg daily (n = 17) | 8 first-line, 26 relapsed-refractory | Aspirin 1; rivaroxaban 0 | Aspirin: 0 MB, 1 CRNMB Rivaroxaban: 0 MB, 0 CRNMB |
| Sayar et al (2022)16 | Prospective, single arm† | Aspirin (n = 47) Apixaban 2.5 mg twice daily (n = 60) Prophylactic LMWH (n = 6) Clopidogrel (n = 1) No prophylaxis (n = 33) | 28 first-line, 119 relapsed- refractory | Aspirin 1; apixaban 0; LMWH 0; clopidogrel 0; no prophylaxis 1 | Aspirin: 1 MB, 0 CRNMB Apixaban: 0 MB, 1 CRNMB LMWH 0: 0 MB, 0 CRNMB Clopidogrel: 0 MB, 0 CRNMB No prophylaxis: 0 MB, 0 CRNMB |
| Cornell et al (2019)17 | Prospective, single arm | Apixaban 2.5 mg twice daily (n = 50) | 2 first-line, 18 relapsed-refractory, 10 consolidation, 20 maintenance | No VTE | 0 MB, 3 CRNMB |
| Pegourie et al (2019)18 | Prospective, single arm | Apixaban 2.5 mg twice daily (n = 50) | 11 first-line, 93 relapsed-refractory | 2 VTE | 1 MB, 11 CRNMB |
| Piedra et al (2022)19 | Retrospective | Aspirin 81 mg daily (n = 221) Aspirin 325 mg daily (n = 2) Rivaroxaban 10 mg daily (n = 82) | 305 first-line | Aspirin 24; rivaroxaban 4 | Aspirin: 0 MB, 6 CRNMB Rivaroxaban: 0 MB, 1 CRNMB |
| Storrar et al (2018)20 | Retrospective | Apixaban 2.5 mg twice daily (n = 70) | 70 first-line | No VTE | 1 MB, CRNMB NR |
CRNMB, clinically relevant nonmajor bleeding; CVC, central venous catheter; LMWH, low-molecular-weight heparin; MB, major bleed; NR, not reported.
Retrospective studies with at least 50 patients are included.
Sayar et al16 also presented a retrospective cohort; however, only the prospective cohort is presented here.