新型口服抗凝药治疗肿瘤相关静脉血栓栓塞症网状Meta分析OACSTPCD

Objective To systematically review the efficacy and safety of different novel oral anticoagulants(NOACs)in the treatment of cancer-associated venous thromboembolism(CAVTE).Methods Random controlled trials(RCTs)related to NOACs in the treatment of CAVTE were retrieved from the CNKI,CBM,WanFang,VIP,PubMed,The Cochrane Library,and Embase databases from the inception of each database to February 28,2023.The quality of the included studies was evaluated by the Cochrane system evaluation manual,the risk assessment was conducted by the RevMan 5.3 software and the network Meta-analysis was performed by the Stata 16.0 software.Results Ten studies were included,involving 12 RCTs,5 080 patients,and five intervention measures.The network Meta-analysis results showed that in terms of efficacy endpoints,rivaroxaban was the optimal choice when considering the all-cause mortality and deep vein thrombosis recurrence rate,apixaban was the optimal choice when considering the efficacy endpoints of VTE recurrence rate and pulmonary embolism recurrence rate;in terms of safety endpoints,rivaroxaban was the optimal choice when considering major bleeding rate,clinically relevant non-major bleeding rate,and clinically relevant bleeding rate.Conclusion Based on the comprehensive evaluation of efficacy and safety,rivaroxaban can be considered as the preferred choice when selecting NOACs for the clinical treatment of CAVTE.