Niedermolekulares Heparin bei Tumor-assoziierter venöser Thromboembolie – immer noch „CATCH of the day“?

Zusammenfassung

Im Dezember 2014 wurde auf dem Jahreskongress der American Society of Hematology die CATCH-Studie vorgestellt. Sie vergleicht die Gabe des niedermolekularen Heparins Tinzaparin mit dem Vitamin-K-Antagonisten Warfarin in der 6-monatigen Lang-zeittherapie (Sekundärprophylaxe) nach Tumor-assoziierter venöser Thrombose oder Lungenembolie (VTE). Die Studie zeigt, dass 6,9 % der mit Tinzaparin behandelten und 10 % der Warfarin-Patienten eine symptomatische und/oder asymptomatische RezidivThromboembolie entwickelten. Der Unterschied war statistisch nicht signifikant. Wenn man jedoch nur die symptomatischen Thromboembolie-Rezidive betrachtet, war Tinzaparin sogar signifikant besser. Blutungen waren mit Tinzaparin auch nicht häufiger, so genannte nicht-schwerwiegende, aber klinisch relevante Blutungen sogar signifikant seltener. Die CATCH-Studie ist die bisher größte Studie zur Frage der Langzeitantikoagulation nach Tumor-assoziierter VTE. Sie bestätigt die Empfehlung der Fachgesellschaften, dass niedermolekulare Heparine in der Sekundärprophylaxe bei Tumorpatienten mit venöser Thromboembolie den Vitamin-K-Antagonisten vorgezogen werden sollten.

Schlüsselwörter

Tumor-assoziierte Thromboembolie - CATCH - Tinzaparin - NMH

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