{"id":138635,"date":"2024-11-23T00:38:36","date_gmt":"2024-11-23T05:38:36","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=138635"},"modified":"2026-02-12T11:47:26","modified_gmt":"2026-02-12T16:47:26","slug":"rivaroxaban-for-18-months-superior-to-6-months-to-prevent-recurrent-vte-events-in-cancer-patients-with-acute-low-pe-onco-pr","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=138635","title":{"rendered":"Rivaroxaban for 18 Months Superior to 6 Months To Prevent Recurrent VTE Events in Cancer Patients with Acute-low PE: ONCO PE"},"content":{"rendered":"<p><strong>Key Takeaways<\/strong>:<\/p>\n<ul>\n<li>The ONCO PE trial demonstrated that an 18-month treatment with rivaroxaban significantly reduced recurrent venous thromboembolism (VTE) compared to a 6-month treatment in patients with cancer and acute low-risk pulmonary embolism (PE) (5.6% vs. 19.1%; OR, 0.25; 95% CI, 0.09\u20130.72; P=0.01).<\/li>\n<li>There was no statistically significant increase in major bleeding events with the longer rivaroxaban treatment (7.8% vs. 5.6%; OR, 1.43; 95% CI, 0.44\u20134.70; P=0.55).<\/li>\n<li>The study highlights the benefits of extended anticoagulation in preventing thrombotic events in this patient population, though individual bleeding risks must be considered.<\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p>Patients with cancer are at heightened risk of VTE, including pulmonary embolism (PE), a major complication during cancer treatment. Although international guidelines recommend extended anticoagulation therapy for cancer-associated PE, the optimal duration of therapy remains unclear, particularly in those with acute low-risk PE. The ONCO PE trial (ClinicalTrials.gov number, NCT04724460) investigated the efficacy and safety of 18-month versus 6-month rivaroxaban therapy in preventing recurrent VTE in this population.<\/p>\n<p>The ONCO PE trial was a multicenter, open-label, adjudicator-blinded randomized trial conducted at 32 institutions in Japan. The results of the trial were presented at the AHA Scientific Sessions 2024 and simultaneously published in <em>Circulation<\/em>. \u00a0ONCO PE enrolled 178 patients with active cancer and acute low-risk PE, defined by a simplified Pulmonary Embolism Severity Index (sPESI) score of 1. Participants were randomized 1:1 to receive rivaroxaban for either 18 months or 6 months. The primary endpoint was recurrent VTE at 18 months, and the secondary endpoint was major bleeding, evaluated per the International Society on Thrombosis and Haemostasis criteria.<\/p>\n<p>The primary endpoint of recurrent VTE occurred in 5 patients (5.6%) in the 18-month group compared to 17 patients (19.1%) in the 6-month group (OR, 0.25; 95% CI, 0.09\u20130.72; P=0.01). Recurrent events included symptomatic and incidental PEs, as well as deep vein thrombosis. The major secondary endpoint, major bleeding, occurred in 7 patients (7.8%) in the 18-month group versus 5 patients (5.6%) in the 6-month group (OR, 1.43; 95% CI, 0.44\u20134.70; P=0.55). Notably, the most common bleeding site was the gastrointestinal tract. Other outcomes included death from all causes, which occurred in 32.6% of patients in the 18-month group compared to 25.8% in the 6-month group, though these differences were not statistically significant. Symptomatic VTE recurrence was lower in the 18-month group (1.1% vs. 4.5%; OR, 0.24; 95% CI, 0.03\u20132.20).<\/p>\n<p>The findings of the ONCO PE trial highlight the potential of extended rivaroxaban therapy for patients with cancer and low-risk PE, though individual patient risks should guide therapy decisions. Further research may refine these strategies in broader cancer populations.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key Takeaways: The ONCO PE trial demonstrated that an 18-month treatment with rivaroxaban significantly reduced recurrent venous thromboembolism (VTE) compared to a 6-month treatment in patients with cancer and acute low-risk pulmonary embolism (PE) (5.6% vs. 19.1%; OR, 0.25; 95% CI, 0.09\u20130.72; P=0.01). There was no statistically significant increase in major bleeding events with the [&hellip;]<\/p>\n","protected":false},"author":40616,"featured_media":138636,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[896,8],"tags":[897,45,47,185],"ppma_author":[1070],"class_list":{"0":"post-138635","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-aha-2024","8":"category-news","9":"tag-aha-2024","10":"tag-conference","11":"tag-featured","12":"tag-news","13":"author-joseph-kim-md"},"authors":[{"term_id":1070,"user_id":40616,"is_guest":0,"slug":"joseph-kim-md","display_name":"Joseph Kim MD","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/bf0879bf0ca450025acf71d7345cf24be4748f67f7b0c6423d186a5765c5cda9?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138635","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40616"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138635"}],"version-history":[{"count":2,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138635\/revisions"}],"predecessor-version":[{"id":139622,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138635\/revisions\/139622"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/138636"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138635"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138635"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138635"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138635"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}