PMID- 28198064
OWN - NLM
STAT- MEDLINE
DCOM- 20171030
LR  - 20171030
IS  - 1099-1557 (Electronic)
IS  - 1053-8569 (Linking)
VI  - 26
IP  - 5
DP  - 2017 May
TI  - Real-life practices for preventing venous thromboembolism in multiple myeloma 
      patients: a cohort study from the French health insurance database.
PG  - 578-586
LID - 10.1002/pds.4180 [doi]
AB  - PURPOSE: The risk of venous thromboembolic event (VTE) in multiple myeloma is 
      particularly increased. Current guidelines recommend systematic VTE prophylaxis 
      with vitamin K antagonists (VKA) or low weight molecular heparin (LWMH) or 
      unfractionated heparin (UFH) in high-risk patients, based on treatment received 
      [e.g. use of IMiDs (thalidomide, lenalidomide and pomalidomide), alkylating 
      agents or erythropoietin] and individual risk factors (e.g. history of VTE). The 
      aim of this study was to describe strategy of VTE prophylaxis and prescribing of 
      other antithrombotic agents during the first 6 months of multiple myeloma 
      therapy, with stratification on IMiD-based regimens and drug and disease-related 
      risk factors. METHODS: A retrospective cohort study of French beneficiaries from 
      the health insurance database (SNIIRAM, Systeme National d'Information 
      Inter-Regime de l'Assurance Maladie) was designed in the Midi-Pyrenees area 
      (South West France). Patients starting a treatment for multiple myeloma in the 
      period 2011-2014 were identified through hospital and chronic disease diagnoses. 
      RESULTS: Among the 236 incident multiple myeloma patients, 56% male (n = 133), 
      67% >65 years (n = 159) and 47% (n = 110) patients received an IMiD-based 
      regimen. In these patients, 63% (n = 69) were identified as high-risk patients 
      with indication for low molecular weight heparin or equivalent, and 37% (n = 41) 
      were identified as low-risk with aspirin recommended. Among the high-risk IMiDs 
      patients, 43% (30/69) currently received a VTE prophylaxis after starting their 
      first regimen: 70% LWMH (21/30), 40% VKA (12/30), 10% UFH (3/30) and 13% (4/30) 
      other drugs (rivaroxaban and fondaparinux); 33% of the patients (23/69) received 
      an antiplatelet drug only, and 23% (16/69) did not receive any antithrombotic 
      drug. CONCLUSIONS: These results revealed lack of implementation of VTE 
      prophylaxis in one out of high-risk multiple myeloma patients with IMiD. 
      Copyright (c) 2017 John Wiley & Sons, Ltd.
CI  - Copyright (c) 2017 John Wiley & Sons, Ltd.
FAU - Palmaro, Aurore
AU  - Palmaro A
AUID- ORCID: 0000-0002-5660-9224
AD  - Medical and Clinical Pharmacology department, Toulouse University Hospital, 
      Toulouse, France.
AD  - UMR INSERM 1027, University of Toulouse, Toulouse, France.
AD  - CIC 1436, Toulouse University Hospital, Toulouse, France.
FAU - Rouge-Bugat, Marie-Eve
AU  - Rouge-Bugat ME
AD  - UMR INSERM 1027, University of Toulouse, Toulouse, France.
AD  - Academic Department of Family Medicine, Faculty of Medicine Toulouse, University 
      of Toulouse, Toulouse, France.
FAU - Gauthier, Martin
AU  - Gauthier M
AD  - Department of Haematology, Toulouse University Hospital, Toulouse, France.
FAU - Despas, Fabien
AU  - Despas F
AD  - Medical and Clinical Pharmacology department, Toulouse University Hospital, 
      Toulouse, France.
AD  - UMR INSERM 1027, University of Toulouse, Toulouse, France.
AD  - CIC 1436, Toulouse University Hospital, Toulouse, France.
FAU - Moulis, Guillaume
AU  - Moulis G
AD  - Medical and Clinical Pharmacology department, Toulouse University Hospital, 
      Toulouse, France.
AD  - UMR INSERM 1027, University of Toulouse, Toulouse, France.
AD  - CIC 1436, Toulouse University Hospital, Toulouse, France.
AD  - Department of Internal Medicine, Toulouse University Hospital, Toulouse, France.
FAU - Lapeyre-Mestre, Maryse
AU  - Lapeyre-Mestre M
AD  - Medical and Clinical Pharmacology department, Toulouse University Hospital, 
      Toulouse, France.
AD  - UMR INSERM 1027, University of Toulouse, Toulouse, France.
AD  - CIC 1436, Toulouse University Hospital, Toulouse, France.
LA  - eng
PT  - Journal Article
DEP - 20170215
PL  - England
TA  - Pharmacoepidemiol Drug Saf
JT  - Pharmacoepidemiology and drug safety
JID - 9208369
RN  - 0 (Anticoagulants)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 12001-79-5 (Vitamin K)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Antineoplastic Agents/*administration & dosage
MH  - Cohort Studies
MH  - Databases, Factual
MH  - Female
MH  - France/epidemiology
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/complications/*drug therapy
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Practice Guidelines as Topic
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Venous Thromboembolism/etiology/*prevention & control
MH  - Vitamin K/antagonists & inhibitors
OTO - NOTNLM
OT  - France
OT  - SNIIRAM
OT  - electronic healthcare records
OT  - lenalidomide
OT  - multiple myeloma
OT  - pharmacoepidemiology
OT  - thalidomide
OT  - venous thromboembolism
EDAT- 2017/02/16 06:00
MHDA- 2017/10/31 06:00
CRDT- 2017/02/16 06:00
PHST- 2016/06/14 00:00 [received]
PHST- 2016/12/12 00:00 [revised]
PHST- 2017/01/19 00:00 [accepted]
PHST- 2017/02/16 06:00 [pubmed]
PHST- 2017/10/31 06:00 [medline]
PHST- 2017/02/16 06:00 [entrez]
AID - 10.1002/pds.4180 [doi]
PST - ppublish
SO  - Pharmacoepidemiol Drug Saf. 2017 May;26(5):578-586. doi: 10.1002/pds.4180. Epub 
      2017 Feb 15.