PURPOSE: Malignancy is associated with a hypercoagulable state and an increased risk of venous thromboembolism (VTE). Limited data are available on the real-world treatment patterns associated with the antithrombotic agent fondaparinux in this population. This study looked at the use of fondaparinux treatment in cancer patients.
METHODS: Data were extracted from the Varian Medical Oncology database of electronic medical records from 17 outpatient oncology clinics in the US. Adults with any cancer treated with fondaparinux at a dose 5.0mg, 7.5mg, 10.0mg or higher between January 2001 and September 2007 were identified. Demographics, clinical characteristics, chemotherapy regimens, and treatment patterns were derived and summarized.
RESULTS: A total of 101 patients were treated with fondaparinux with the majority receiving a dose of 7.5 mg/day [81.2%]. The mean age of this population was 60.5 years and 58% were women. Approximately 70% had a solid tumor (15% breast, 18% lung, 6% colorectal and 31% other), 8% had hematological malignancies and 7% had multiple diagnoses. Nearly half of the patients had stage IV and/or evidence of metastases. Approximately 79% of patients received chemotherapy. Fondaparinux was administered more frequently after chemotherapy [68%] than concurrently with chemotherapy [11%]. Approximately 59% of patients received concomitant vitamin K inhibitor. Assuming all prescriptions and refills were filled and taken, the median duration of continuous use ranged from 1–402 days (median of 5 days). The median duration of fondaparinux use, allowing for treatment gaps, was 8 days (range 1–480 days). A total of 30 patients used fondaparinux long-term (>30 days), 14 patients for 1–3 months, 8 patients for 3–6 months, and 8 patients for more than 6 months.
CONCLUSION: In this sample of US oncology clinics, 101 patients with varying types of cancers, were treated with fondaparinux for a median of eight days. One-third of these patients were treated for more than 1 month and 8% were for more than 6 months.
CLINICAL IMPLICATIONS: In real-world clinical practice, fondaparinux is used for VTE treatment of various duration in a heterogeneous cancer patient population.
DISCLOSURE: Ruslan Horblyuk, Other United BioSource Corporation received funding for this project from GlaxoSmithKline; No Product/Research Disclosure Information