Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Home Treatment for Active Cancer Patients With Low-Risk Pulmonary Embolism　― A Predetermined Companion Report From the ONCO PE Trial ―
Ryuki Chatani, Yugo Yamashita , Takeshi Morimoto, Nao Muraoka, Wataru Shioyama, Tatsuhiro Shibata, Yuji Nishimoto, Yoshito Ogihara, Kosuke Doi, Maki Oi, Taro Shiga, Daisuke Sueta, Kitae Kim, Yasuhiro Tanabe, Norimichi Koitabashi, Takuma Takada, Satoshi Ikeda, Hitoshi Nakagawa, Takayuki Mitsuhashi, Masaaki Shoji, Jiro Sakamoto, Shinji Hisatake, Yutaka Ogino, Masashi Fujita, Naohiko Nakanishi, Tomohiro Dohke, Seiichi Hiramori, Ryuzo Nawada, Kazuhisa Kaneda, Kazunori Mushiake, Hiromi Yamamoto, Kazushige Kadota, Koh Ono, Takeshi Kimura, on behalf of the ONCO PE Trial Investigators
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Keywords: Anticoagulants, Cancer, Cardio-oncology, Home treatment, Pulmonary embolism
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Article ID: CJ-24-0004

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Abstract

Background: Patients with appropriately selected low-risk pulmonary embolism (PE) can be treated at home, although it has been controversial whether applies to patients with cancer, who are considered not to be at low risk.

Methods and Results: The current predetermined companion report from the ONCO PE trial evaluated the 3-month clinical outcomes of patients with home treatment and those with in-hospital treatment. The ONCO PE trial was a multicenter, randomized clinical trial among 32 institutions in Japan investigating the optimal duration of rivaroxaban treatment in cancer-associated PE patients with a score of 1 using the simplified version of the Pulmonary Embolism Severity Index (sPESI). Among 178 study patients, there were 66 (37%) in the home treatment group and 112 (63%) in the in-hospital treatment group. The primary endpoint of a composite of PE-related death, recurrent venous thromboembolism (VTE) and major bleeding occurred in 3 patients (4.6% [0.0–9.6%]) in the home treatment group and in 2 patients (1.8% [0.0–4.3%]) in the in-hospital treatment group. In the home treatment group, there were no cases of PE-related death or recurrent VTE, but major bleeding occurred in 3 patients (4.6% [0.0–9.6%]), and 2 patients (3.0% [0.0–7.2%]) required hospitalization due to bleeding events.

Conclusions: Active cancer patients with PE of sPESI score=1 could be potential candidates for home treatment.

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© 2024, THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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