Efficacy and safety of venous thromboembolism prevention in lung cancer: a meta-analysis of randomized controlled studies

doi:10.5246/jcps.2023.10.069

Abstract

Abstract:

Venous thromboembolism (VTE) is a significant complication and a risk factor for mortality in patients with lung tumors. Anticoagulation therapy plays a crucial role in the prevention of VTE. However, its safety and effectiveness, specifically in lung cancer patients, have not been systematically evaluated. This study aimed to conduct a meta-analysis to assess the efficacy and safety of prophylactic anticoagulation in patients with lung cancer. We systematically searched for relevant literature published in Pubmed, Embase, CNKI, and Wanfang databases until September 2020 and screened the literature according to predefined inclusion and exclusion criteria. The included studies were evaluated for quality using the modified Jadad scale, and Review Manager 5.4 software was used for data analysis. Four randomized controlled trials (n = 2272 participants) were included in the meta-analysis. The quality evaluation revealed that two articles were of high quality (≥ 4 points), while the remaining articles were of low quality (≤ 3 points). The average Jadad score for all references was 3.5. The meta-analyses demonstrated that anticoagulant therapy significantly reduced the incidence of VTE in lung cancer patients [RR = 0.55, 95% CI (0.43, 0.70), P < 0.00001]. However, there were no statistically significant differences in the incidence of total bleeding [RR = 1.74, 95% CI (0.87, 3.50), P = 0.12], minor bleeding [RR = 1.64, 95% CI (0.66, 4.05), P = 0.29], and major bleeding [RR = 1.70, 95% CI (0.91, 3.16), P = 0.10]. In conclusion, anticoagulant therapy effectively reduced the incidence of VTE in lung cancer patients without a statistically significant increase in bleeding complications.

Key words: Lung neoplasms, Venous thromboembolism, Anticoagulant therapy, Hemorrhage, Meta-analysis

Supporting:

Limei Su, Xiyue Mao, Limei Yang. Efficacy and safety of venous thromboembolism prevention in lung cancer: a meta-analysis of randomized controlled studies[J]. Journal of Chinese Pharmaceutical Sciences, 2023, 32(10): 852-860.

Figures/Tables 9

Table 1. Characteristics of included studies.

Table 2. Jadad scores for the included studies.

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