Traitement anticoagulant prolongé avec une dose réduite d’apixaban chez les patients cancéreux atteints d’une maladie thromboembolique veineuse (étude API-CAT)

Épisode de BaladoCritique - club de lecture médical par Dr Luc Lanthier et collaborateurs · 28 mai 2025 · 38 min

Dans cette 71e baladodiffusion, les Drs Luc Lanthier et Geneviève LeTemplier discutent du traitement de la maladie thromboembolique paranéoplasique, en plus de réviser la littérature médicale d’avril 2025.

Quiz clinique (2 min 04), présentation principale (2 min 29), critique (25 min 44), retour sur le cas clinique (31 min 15), autres articles (32 min 35), réponse au quiz clinique (35 min 15)

Référence principale :

Mahe I, Carrier M, Mayeur D, Chidiac J, Vicaut E, Falvo N, et al. Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism. N Engl J Med. 2025;392(14):1363-73. PubMed PMID: 40162636.

Articles associés :

Noble S. Cancer-Associated Venous Thromboembolism – Beyond 6 Months. N Engl J Med. 2025;392(14):1439-40. PubMed PMID: 40162659.

Lee AY, Levine MN, Baker RI, Bowden C, Kakkar AK, Prins M, et al; Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer (CLOT) Investigators. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003;349(2):146-53. PubMed PMID: 12853587.

Raskob GE, van Es N, Verhamme P, Carrier M, Di Nisio M, Garcia D, et al; Hokusai VTE Cancer Investigators. Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism. N Engl J Med. 2018;378(7):615-624. PubMed PMID: 29231094.

Agnelli G, Becattini C, Meyer G, Munoz A, Huisman MV, Connors JM, et al. Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer. N Engl J Med. 2020;382(17):1599-607. PubMed PMID: 32233112.

Agnelli G, Buller HR, Cohen A, Curto M, Gallus AS, Johnson M, Porcari A, Raskob GE, Weitz JI; AMPLIFY-EXT Investigators. Apixaban for extended treatment of venous thromboembolism. N Engl J Med. 2013;368(8):699-708. PubMed PMID: 23216615.

Weitz JI, Lensing AWA, Prins MH, Bauersachs R, Beyer-Westendorf J, Bounameaux H, et al; EINSTEIN CHOICE Investigators. Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism. N Engl J Med. 2017;376(13):1211-1222. PubMed PMID: 28316279.

Lyman GH, Carrier M, Ay C, Di Nisio M, Hicks LK, Khorana AA, et al. American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer. Blood Adv. 2021;5(4):927-974. PubMed PMID: 33570602.

Key NS, Khorana AA, Kuderer NM, Bohlke K, Lee AYY, Arcelus JI, et al. Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Guideline Update. J Clin Oncol. 2023;41(16):3063-3071. PubMed PMID: 37075273.

Stevens SM, Woller SC, Baumann Kreuziger L, Bounameaux H, Doerschug K, Geersing GJ, et al. Executive Summary: Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160(6):2247-2259. PubMed PMID: 34352279.

Autres articles d’intérêt récent :

Kelley CF, Acevedo-Quinones M, Agwu AL, Avihingsanon A, Benson P, Blumenthal J, et al. Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons. N Engl J Med. 2025;392(13):1261-76. PubMed PMID: 39602624.

Choi KH, Park YH, Lee JY, Jeong JO, Kim CJ, Yun KH, et al. Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial. Lancet. 2025;405(10486):1252-63. PubMed PMID: 40174599.

Raposeiras-Roubin S, Amat-Santos IJ, Rossello X, Gonzalez Ferreiro R, Gonzalez Bermudez I, Lopez Otero D, et al. Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve Implantation. N Engl J Med. 2025;392(14):1396-405. PubMed PMID: 40162639.

Yan S, Zhou Y, Lansberg MG, Liebeskind DS, Yuan C, Yu H, et al. Alteplase for Posterior Circulation Ischemic Stroke at 4.5 to 24 Hours. N Engl J Med. 2025;392(13):1288-96. PubMed PMID: 40174223.

Monto AS, Kuhlbusch K, Bernasconi C, Cao B, Cohen HA, Graham E, et al. Efficacy of Baloxavir Treatment in Preventing Transmission of Influenza. N Engl J Med. 2025;392(16):1582-1593. PubMed PMID: 40267424.

Thouvenot E, Laplaud D, Lebrun-Frenay C, Derache N, Le Page E, Maillart E, et al; D-Lay MS Investigators. High-Dose Vitamin D in Clinically Isolated Syndrome Typical of Multiple Sclerosis: The D-Lay MS Randomized Clinical Trial. JAMA. 2025;333(16):1413-1422. PubMed PMID: 40063041.

Guides de pratique :

Rao SV, O’Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;151(13):e771-e862. PubMed PMID: 40014670.

Sinha SS, Morrow DA, Kapur NK, Kataria R, Roswell RO. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Evaluation and Management of Cardiogenic Shock: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2025;85(16):1618-41. PubMed PMID: 40100174.

DeSimone DC, Garrigos ZE, Marx GE, Tattevin P, Hasse B, McCormick DW, et al. Blood Culture-Negative Endocarditis: A Scientific Statement From the American Heart Association: Endorsed by the International Society for Cardiovascular Infectious Diseases. J Am Heart Assoc. 2025;14(8):e040218. PubMed PMID: 40094211.

Hernandez P, Bosse Y, Bush P, Chapman KR, Maltais F, Penz ED, et al. Alpha-1-Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Meta-Analysis and Clinical Practice Guideline. Chest. 2025;167(4):1044-63. PubMed PMID: 39880301.

Référence du quiz clinique :

Vasan RS, Enserro DM, Beiser AS, Xanthakis V. Lifetime Risk of Heart Failure Among Participants in the Framingham Study. J Am Coll Cardiol. 2022;79(3):250-263. PubMed PMID: 35057911.

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