Low-molecular-weight heparin beyond 12 months in patients with cancer-associated thrombosis

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Clinical guidelines indicate that in patients with cancer-associated thrombosis (CAT), anticoagulant treatment should be continued beyond 6 months as long as the cancer is active. We aimed


to analyse the safety of low-molecular-weight heparin (LMWH) beyond 12 months in patients with CAT.


We performed a post hoc analysis of consecutive CAT patients from October 2008 to December 2019. The primary outcome was the rate of clinically relevant bleeding (CRB), and we compared two


periods (1–12 vs. 12–24 months). Hazard ratio (HR), competing risk analysis and sensitivity analyses were performed.


Of the 588 patients included, 30.1% (n = 177) received LMWH beyond 12 months. The rate of CRB in the first 12 months compared to the 12–24 month period was 3.2 per 100 patients/month (95% CI


2.5–4.1) vs. 0.9 per 100 patients/month (95% CI 0.4–1.5), (P