Anticoagulation for the initial treatment of venous thromboembolism in patients with cancer.

Abstract:

BACKGROUND:Compared to patients without cancer, patients with cancer who receive anticoagulant treatment for venous thromboembolism are more likely to develop recurrent venous thromboembolism (VTE). OBJECTIVES:To compare the efficacy and safety of three types of parenteral anticoagulants for the initial treatment of VTE in patients with cancer. SEARCH STRATEGY:A comprehensive search for studies of anticoagulation in cancer patients including a February 2010 electronic search of: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and ISI Web of Science. SELECTION CRITERIA:Randomized clinical trials (RCTs) comparing low molecular weight heparin (LMWH), unfractionated heparin (UFH), and fondaparinux in patients with cancer and objectively confirmed VTE. DATA COLLECTION AND ANALYSIS:Using a standardized data form, data was extracted in duplicate on methodological quality, participants, interventions, and outcomes of interest that included mortality, recurrent VTE, major bleeding, minor bleeding, postphlebitic syndrome, quality of life, and thrombocytopenia. MAIN RESULTS:Of 3986 identified citations, 16 RCTs were eligible: 13 compared LMWH to UFH, two compared fondaparinux to heparin, and one compared dalteparin to tinzaparin. Meta-analysis of 11 studies showed a statistically significant reduction in mortality at three months of follow up with LMWH compared with UFH (relative risk (RR) 0.71; 95% confidence interval (CI) 0.52 to 0.98). There was little change in the effect estimate after excluding studies of lower methodological quality (RR 0.72; 95% CI 0.52 to 1.00). A meta-analysis of three studies comparing LMWH with UFH showed no statistically significant reduction in VTE recurrence (RR 0.78; 95% CI 0.29 to 2.08). The overall quality of evidence was low for LMWH versus UFH due to imprecision and likely publication bias. There were no statistically significant differences between heparin and fondaparinux for the outcomes of death (RR 1.27; 95% CI 0.88 to 1.84), recurrent VTE (RR 0.95; 95% CI 0.57 to 1.60), major bleeding (RR 0.79; 95% CI 0.39 to1.63) or minor bleeding (RR 1.50; 95% CI 0.87 to 2.59). The one study comparing dalteparin to tinzaparin did not find a statistically significant difference in mortality (RR 0.86; 95% CI 0.43 to 1.73). AUTHORS' CONCLUSIONS:LMWH is possibly superior to UFH in the initial treatment of VTE in patients with cancer. Additional trials focusing on patient important outcomes will further inform the questions addressed in this review.

authors

Akl EA,Vasireddi SR,Gunukula S,Barba M,Sperati F,Terrenato I,Muti P,Schünemann H

doi

10.1002/14651858.CD006649.pub5

subject

Has Abstract

pub_date

2011-06-15 00:00:00

pages

CD006649

issue

6

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Immediate post-abortal insertion of intrauterine devices.

    abstract:OBJECTIVES:To assess the safety and efficacy of IUD insertion immediately after spontaneous or induced abortion. SEARCH STRATEGY:We used Medline, Popline, and EMBASE computer searches, supplemented by review articles and contacts with investigators. SELECTION CRITERIA:We sought all randomized controlled trials that h...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001777

    authors: Grimes D,Schulz K,Stanwood N

    更新日期:2000-01-01 00:00:00

  • Pre-operative chemoradiation for non-metastatic locally advanced rectal cancer.

    abstract:BACKGROUND:This review sets out to assess the efficacy of pre-operative chemoradiation when compared to radiotherapy alone before surgery in the treatment of advanced non metastatic rectal surgery. OBJECTIVES:To determine the efficacy of pre-operative chemoradiation (CRT) compared with radiation (RT) alone, in locally...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008368.pub2

    authors: McCarthy K,Pearson K,Fulton R,Hewitt J

    更新日期:2012-12-12 00:00:00

  • Pharmacological interventions for obsessive-compulsive personality disorder.

    abstract::This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the potential beneficial and adverse effects of pharmacological interventions for people with obsessive-compulsive personality disorder and to make recommendations for future areas of research. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD008517

    authors: Alex R,Ferriter M,Jones H,Huband N,Duggan C,Völlm BA,Stoffers J,Lieb K

    更新日期:2010-01-01 00:00:00

  • Electromagnetic field stimulation for treating delayed union or non-union of long bone fractures in adults.

    abstract:BACKGROUND:Delayed union and non-union of fractures are a considerable cause of morbidity to patients. Laboratory studies have shown that electromagnetic fields can stimulate the formation of new bone, indicating a potential role for electromagnetic stimulation in the treatment of fractures that have failed to heal. O...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008471.pub2

    authors: Griffin XL,Costa ML,Parsons N,Smith N

    更新日期:2011-04-13 00:00:00

  • Interventions for sexual dysfunction following treatments for cancer in women.

    abstract:BACKGROUND:The proportion of people living with and surviving cancer is growing. This has led to increased awareness of the importance of quality of life, including sexual function, in those affected by cancer. Sexual dysfunction is a potential long-term complication of many cancer treatments. This includes treatments ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005540.pub3

    authors: Candy B,Jones L,Vickerstaff V,Tookman A,King M

    更新日期:2016-02-02 00:00:00

  • Comprehensive geriatric assessment for older adults admitted to hospital.

    abstract:BACKGROUND:Comprehensive geriatric assessment (CGA) is a multi-dimensional, multi-disciplinary diagnostic and therapeutic process conducted to determine the medical, mental, and functional problems of older people with frailty so that a co-ordinated and integrated plan for treatment and follow-up can be developed. This...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006211.pub3

    authors: Ellis G,Gardner M,Tsiachristas A,Langhorne P,Burke O,Harwood RH,Conroy SP,Kircher T,Somme D,Saltvedt I,Wald H,O'Neill D,Robinson D,Shepperd S

    更新日期:2017-09-12 00:00:00

  • Anticholinergic therapy for chronic asthma in children over two years of age.

    abstract:BACKGROUND:In the intrinsic system of controlling airway calibre, the cholinergic (muscarinic) sympathetic nervous system has an important role. Anticholinergic, anti muscarinic bronchodilators such as ipratropium bromide are frequently used in the management of childhood airway disease. In asthma, ipratropium is a les...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003535

    authors: McDonald NJ,Bara AI

    更新日期:2003-01-01 00:00:00

  • Exercise-based rehabilitation for heart failure.

    abstract:BACKGROUND:Previous systematic reviews and meta-analyses consistently show the positive effect of exercise-based rehabilitation for heart failure (HF) on exercise capacity; however, the direction and magnitude of effects on health-related quality of life, mortality and hospital admissions in HF remain less certain. Thi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003331.pub4

    authors: Taylor RS,Sagar VA,Davies EJ,Briscoe S,Coats AJ,Dalal H,Lough F,Rees K,Singh S

    更新日期:2014-04-27 00:00:00

  • Self-management education programmes for osteoarthritis.

    abstract:BACKGROUND:Self-management education programmes are complex interventions specifically targeted at patient education and behaviour modification. They are designed to encourage people with chronic disease to take an active self-management role to supplement medical care and improve outcomes. OBJECTIVES:To assess the ef...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008963.pub2

    authors: Kroon FP,van der Burg LR,Buchbinder R,Osborne RH,Johnston RV,Pitt V

    更新日期:2014-01-15 00:00:00

  • Computer-assisted versus oral-and-written dietary history taking for diabetes mellitus.

    abstract:BACKGROUND:Diabetes is a chronic illness characterised by insulin resistance or deficiency, resulting in elevated glycosylated haemoglobin A1c (HbA1c) levels. Diet and adherence to dietary advice is associated with lower HbA1c levels and control of disease. Dietary history may be an effective clinical tool for diabetes...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008488.pub2

    authors: Wei I,Pappas Y,Car J,Sheikh A,Majeed A

    更新日期:2011-12-07 00:00:00

  • Prevention versus treatment for malaria in pregnant women.

    abstract:OBJECTIVES:Malaria contributes to antenatal anaemia and slowing of fetal growth, especially in first-time mothers. It is thought that these effects harm the mother and baby, and interventions to prevent or mitigate the effects of malaria are often recommended. The objective of this review was to assess the effects of a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000169

    authors: Garner P,Gülmezoglu AM

    更新日期:2000-01-01 00:00:00

  • First aid interventions by laypeople for acute oral poisoning.

    abstract:BACKGROUND:Oral poisoning is a major cause of mortality and disability worldwide, with estimates of over 100,000 deaths due to unintentional poisoning each year and an overrepresentation of children below five years of age. Any effective intervention that laypeople can apply to limit or delay uptake or to evacuate, dil...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD013230

    authors: Avau B,Borra V,Vanhove AC,Vandekerckhove P,De Paepe P,De Buck E

    更新日期:2018-12-19 00:00:00

  • Cholinesterase inhibitors for rarer dementias associated with neurological conditions.

    abstract:BACKGROUND:Rarer dementias include Huntington's disease (HD), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), frontotemporal dementia (FTD), dementia in multiple sclerosis (MS) and progressive supranuclear palsy (PSP). Cholinesterase inhibitors, including donepezil,...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009444.pub3

    authors: Li Y,Hai S,Zhou Y,Dong BR

    更新日期:2015-03-03 00:00:00

  • Trihexyphenidyl for dystonia in cerebral palsy.

    abstract:BACKGROUND:Cerebral palsy occurs in up to 2.1 of every 1000 live births and encompasses a range of motor problems and movement disorders. One commonly occurring movement disorder amongst those with cerebral palsy is dystonia: sustained or intermittent involuntary muscle spasms and contractions that cause twisting, repe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD012430.pub2

    authors: Harvey AR,Baker LB,Reddihough DS,Scheinberg A,Williams K

    更新日期:2018-05-15 00:00:00

  • Benzodiazepine receptor antagonists for acute and chronic hepatic encephalopathy.

    abstract:BACKGROUND:The pathogenesis of hepatic encephalopathy is unknown. It has been suggested that liver failure leads to the accumulation of substances that bind to a receptor-complex in the brain resulting in neural inhibition which may progress to coma. Several trials have assessed benzodiazepine receptor antagonists for ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002798

    authors: Als-Nielsen B,Kjaergard LL,Gluud C

    更新日期:2001-01-01 00:00:00

  • Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome.

    abstract:BACKGROUND:Amniotic fluid volume is an important parameter in the assessment of fetal well-being. Oligohydramnios occurs in many high-risk conditions and is associated with poor perinatal outcomes. Many caregivers practice planned delivery by induction of labor or caesarean section after diagnosis of decreased amniotic...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006593.pub2

    authors: Nabhan AF,Abdelmoula YA

    更新日期:2008-07-16 00:00:00

  • Endothelial keratoplasty versus penetrating keratoplasty for Fuchs endothelial dystrophy.

    abstract:BACKGROUND:Fuchs endothelial dystrophy (FED), first described by Ernst Fuchsis in 1910, is a condition in which there is premature degeneration of corneal endothelial cells. When the number of endothelial cells is reduced to a significant degree fluid begins to accumulate within the cornea. As a result the cornea loses...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008420.pub2

    authors: Nanavaty MA,Shortt AJ

    更新日期:2011-07-06 00:00:00

  • Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion.

    abstract:BACKGROUND:Concerns regarding the safety of transfused blood have led to the development of a range of interventions to minimise blood loss during major surgery. Anti-fibrinolytic drugs are widely used, particularly in cardiac surgery and previous reviews have found them to be effective in reducing blood loss and the n...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001886.pub2

    authors: Henry DA,Carless PA,Moxey AJ,O'Connell D,Stokes BJ,McClelland B,Laupacis A,Fergusson D

    更新日期:2007-10-17 00:00:00

  • Physical rehabilitation approaches for the recovery of function and mobility following stroke.

    abstract:BACKGROUND:Various approaches to physical rehabilitation may be used after stroke, and considerable controversy and debate surround the effectiveness of relative approaches. Some physiotherapists base their treatments on a single approach; others use a mixture of components from several different approaches. OBJECTIVE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001920.pub3

    authors: Pollock A,Baer G,Campbell P,Choo PL,Forster A,Morris J,Pomeroy VM,Langhorne P

    更新日期:2014-04-22 00:00:00

  • Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children.

    abstract:BACKGROUND:Faecal incontinence is a common and potentially distressing disorder of childhood. OBJECTIVES:To assess the effects of behavioural and/or cognitive interventions for the management of faecal incontinence in children. SEARCH METHODS:We searched the Cochrane Incontinence Group Specialised Trials Register (se...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002240.pub4

    authors: Brazzelli M,Griffiths PV,Cody JD,Tappin D

    更新日期:2011-12-07 00:00:00

  • Oral H1 antihistamines as monotherapy for eczema.

    abstract:BACKGROUND:Eczema is a common skin disease in many countries, and although the majority of cases of eczema occur before the age of five years and often resolve during childhood or adolescence, it can also persist into adulthood. Itch is the most important aspect of eczema, often impacting significantly on the quality o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007770.pub2

    authors: Apfelbacher CJ,van Zuuren EJ,Fedorowicz Z,Jupiter A,Matterne U,Weisshaar E

    更新日期:2013-02-28 00:00:00

  • Local corticosteroid injection for carpal tunnel syndrome.

    abstract:BACKGROUND:Carpal tunnel syndrome is a clinical syndrome manifested by signs and symptoms of irritation of the median nerve at the level of the carpal tunnel in the wrist. Local corticosteroid injection for carpal tunnel syndrome has been studied but its effectiveness and duration of benefit of local corticosteroid inj...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001554

    authors: Marshall S,Tardif G,Ashworth N

    更新日期:2002-01-01 00:00:00

  • Vitamin supplementation for preventing miscarriage.

    abstract:BACKGROUND:Miscarriage is a common complication of pregnancy that can be caused by a wide range of factors. Poor dietary intake of vitamins has been associated with an increased risk of miscarriage, therefore supplementing women with vitamins either prior to or in early pregnancy may help prevent miscarriage. OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004073.pub3

    authors: Rumbold A,Middleton P,Pan N,Crowther CA

    更新日期:2011-01-19 00:00:00

  • Non-steroidal anti-inflammatory drugs and perioperative bleeding in paediatric tonsillectomy.

    abstract:BACKGROUND:Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for pain relief following tonsillectomy in children. However, as they inhibit platelet aggregation and prolong bleeding time, they could cause increased perioperative bleeding. The overall risk remains unclear. OBJECTIVES:The primary objective of this r...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003591.pub2

    authors: Cardwell M,Siviter G,Smith A

    更新日期:2005-04-18 00:00:00

  • Debridement for surgical wounds.

    abstract:BACKGROUND:Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. OBJECTIVES:To determine the effect of dif...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006214.pub3

    authors: Smith F,Dryburgh N,Donaldson J,Mitchell M

    更新日期:2011-05-11 00:00:00

  • Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Inhaled corticosteroids (ICS) are anti-inflammatory drugs that have proven benefits for people with worsening symptoms of chronic obstructive pulmonary disease (COPD) and repeated exacerbations. They are commonly used as combination inhalers with long-acting beta2-agonists (LABA) to reduce exacerbation rates...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010115.pub2

    authors: Kew KM,Seniukovich A

    更新日期:2014-03-10 00:00:00

  • Polyunsaturated fatty acid supplementation for schizophrenia.

    abstract:BACKGROUND:Limited evidence supports a hypothesis suggesting that schizophrenic symptoms may be the result of altered neuronal membrane structure and metabolism. This structure and metabolism is dependent on blood plasma levels of certain essential fatty acids and their metabolites. OBJECTIVES:To review the effects po...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001257

    authors: Joy CB,Mumby-Croft R,Joy LA

    更新日期:2003-01-01 00:00:00

  • Strategies for managing sexual dysfunction induced by antidepressant medication.

    abstract:BACKGROUND:Sexual dysfunction (including altered desire, orgasmic dysfunction, erectile and ejaculatory problems) is a relatively common side effect of antidepressant medication. These sexual side effects may compromise a person's lifestyle and result in a lack of compliance with the prescribed antidepressant to the de...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003382.pub2

    authors: Rudkin L,Taylor MJ,Hawton K

    更新日期:2004-10-18 00:00:00

  • End-of-life care pathways for improving outcomes in caring for the dying.

    abstract:BACKGROUND:In many clinical areas, integrated care pathways are utilised as structured multidisciplinary care plans which detail essential steps in caring for patients with specific clinical problems. Particularly, care pathways for the dying have been developed as a model to improve the end-of-life care of all patient...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008006.pub2

    authors: Chan R,Webster J

    更新日期:2010-01-20 00:00:00

  • Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome.

    abstract:BACKGROUND:Problems in inducing ovulation in women with polycystic ovary syndrome (PCOS) and anovulation (failure to ovulate) are well recognised. Surgical ovarian wedge resection was the first established treatment for anovulatory PCOS patients but was largely abandoned because of the risk of post-surgical adhesion fo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001122

    authors: Farquhar C,Vandekerckhove P,Lilford R

    更新日期:2001-01-01 00:00:00