ArticleResearch and practice in thrombosis and haemostasis2025
Comparative safety of enoxaparin versus other low-molecular-weight heparins in cancer-associated venous thromboembolism: a real-world cohort study from RIETE.
Article in Research and practice in thrombosis and haemostasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Apixaban Versus LMWH in CAT/VTE: A Comment on Clinical and Methodological Heterogeneity.Cardiovascular drugs and therapy · 2026Article
- Long-term enoxaparin use and osteoporosis risk: a real-world cohort study with integrative computational and network toxicology approaches.Journal of translational medicine · 2026Article
- Direct Oral Anticoagulants Versus Low-Molecular-Weight Heparin for Treating Venous Thromboembolism in Patients With Gastrointestinal Cancer.Cancer medicine · 2026Article
- Clinical risk factors and machine learning for venous thromboembolism in lung cancer: an exploratory single-center study.Frontiers in medicine · 2026Article
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Authors and funding
11 authors.
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Abstract
Background: Low-molecular-weight heparins (LMWHs) are widely used in the treatment of cancer-associated venous thromboembolism (VTE), yet their long-term safety profiles remain insufficiently compared in clinical practice. Objectives: The primary outcome was major bleeding over a 6-month follow-up. Secondary outcomes included VTE recurrence, non-major clinically relevant bleeding, and all-cause mortality. Methods: We analyzed 7287 patients with active cancer and acute VTE from the RIETE registry (2009-2022) who were treated with full-dose enoxaparin ( Results: Major bleeding occurred in 3.84% of patients receiving enoxaparin versus 2.53% in the tinzaparin/dalteparin group (adjusted hazard ratio [aHR] 1.56; 95% CI: 1.11-2.19), with consistent findings across all sensitivity analyses. Enoxaparin was also associated with higher all-cause mortality (28.3% vs 25.1%; aHR 1.22; 95% CI: 1.09-1.37). No significant differences were observed in VTE recurrence (3.59% vs 3.07%) or non-major bleeding (3.98% vs 3.25%). Importantly, during the first 10 days of therapy, major bleeding occurred in 1.2% of patients treated with enoxaparin twice-daily, compared to 0.4% with once-daily dosing and 0.1% in the tinzaparin/dalteparin group ( Conclusion: In this large, observational study, enoxaparin, particularly in twice-daily regimens, was associated with significantly increased risks of bleeding and mortality compared to tinzaparin/dalteparin. These findings may help refine LMWH selection and dosing strategies in patients with cancer-associated VTE and warrant further investigation in prospective studies.
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