Treatment patterns in patients with cancer-associated venous thromboembolism in the US: A real world retrospective database analysis

Background: Cancer patients have higher risk of venous thromboembolism (VTE) due to the cancer-induced hypercoagulable state or activation of the coagulation cascade by chemotherapy. The 2018 National Comprehensive Cancer Network guidelines recommend low molecular weight heparin (LMWH) to treat cancer-associated VTE and direct oral anticoagulants (DOACs) in some circumstances. This study aimed to understand VTE treatment patterns in a cancer-associated VTE population during hospitalization and post-discharge. Methods: Patients with cancer-associated VTE and their respective treatments were identified in IQVIA’s hospital Charge Data Master database from 7/1/15 to 4/30/18. Patients were followed for 1 month after VTE hospitalization. Post-discharge therapy was obtained from outpatient medical and pharmacy claims data. Results: A total of 5,920 cancer patients hospitalized for VTE (54% female; mean age 65.9 [SD=13.0] years) were included. Lung (20%) and breast (13%) cancers were the most common cancer types. Average length of stay was 5.3 days (SD=4.1). 5,366 (91%) patients were treated during the hospital stay; LMWH (51%), DOACs (15%) and warfarin (12%) were the most common inpatient treatments. Within 30 days after discharge, the most common treatments were DOACs (26%) and LMWH (16%); 2,858 (48%) had no observed treatment in the outpatient setting. After discharge, 1,272 (21%) patients remained on the same therapy and 1,436 (24%) switched to a new treatment. Among those patients initiating DOACs (N=865) during hospitalization, 46% remained on DOACs after discharge. Conclusions: In US hospital and outpatient settings, this real world study showed that LMWH treatment and treatment with DOACs were the most common initial inpatient therapies for cancer-associated VTE. DOACs were the most common post discharge treatment. Further investigation of patients without continued treatment within 30 days of discharge is warranted. Citation Format: Jennifer D. Guo, Patrick Hlavacek, Tayla Poretta, Gail Wygant, Daniel C. Lane, Magdaliz Gorritz, Xin Wang, Chi-Chang Chen, Xianying Pan, Lisa Rosenblatt. Treatment patterns in patients with cancer-associated venous thromboembolism in the US: A real world retrospective database analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3367.