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Article ; Online: Cancer-associated venous thrombosis in adults (second edition): A British Society for Haematology Guideline.

Alikhan, Raza / Gomez, Keith / Maraveyas, Anthony / Noble, Simon / Young, Annie / Thomas, Mari

2024

Abstract: A shared decision on the most appropriate agent for the treatment of cancer-associated thrombosis should consider the following factors, which should be reassessed as patients continue along their cancer care pathway: risk of bleeding; tumour site; ... ...

Abstract	A shared decision on the most appropriate agent for the treatment of cancer-associated thrombosis should consider the following factors, which should be reassessed as patients continue along their cancer care pathway: risk of bleeding; tumour site; suitability of oral medications; potential for drug-drug interactions; and patient preference and values regarding choice of drug. Continuing anticoagulation beyond 6 months in patients with cancer-associated venous thromboembolism and active cancer is recommended.
Language	English
Publishing date	2024-04-25
Publishing country	England
Document type	Journal Article
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.19414
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Article ; Online: A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures.

Lester, Will / Bent, Clare / Alikhan, Raza / Roberts, Laura / Gordon-Walker, Tim / Trenfield, Sarah / White, Richard / Forde, Colm / Arachchillage, Deepa J

British journal of haematology

2024

Language	English
Publishing date	2024-03-22
Publishing country	England
Document type	Journal Article
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.19360
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Article ; Online: Diagnosis of pulmonary embolism: should we wait YEARS?

Alikhan, Raza / Roberts, Heledd

British journal of haematology

2018 Volume 183, Issue 2, Page(s) 165–167

MeSH term(s)	Algorithms ; Biomarkers/blood ; Computed Tomography Angiography ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Pulmonary Embolism/diagnosis ; Risk Assessment/methods ; Unnecessary Procedures ; Venous Thrombosis/diagnosis
Chemical Substances	Biomarkers ; Fibrin Fibrinogen Degradation Products ; fibrin fragment D
Language	English
Publishing date	2018-09-10
Publishing country	England
Document type	Editorial
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.15555
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Early Time Courses of Recurrent Venous Thromboembolism and Bleeding during Apixaban or Dalteparin Therapy for Patients with Cancer.

Cohen, Alexander T / Creeper, Katherine J / Alikhan, Raza / Er, Chaozer / Connors, Jean M / Huisman, Menno V / Munoz, Andres / Vescovo, Giorgio / Bauersachs, Rupert / Ageno, Walter / Agnelli, Giancarlo / Becattini, Cecilia

Thrombosis and haemostasis

2024

Abstract: Background: In patients with acute venous thromboembolism (VTE), the rates of recurrence and major bleeding are highest during the first weeks of anticoagulation. The CARAVAGGIO trial demonstrated noninferiority of apixaban to dalteparin for treatment ... ...

Abstract	Background: In patients with acute venous thromboembolism (VTE), the rates of recurrence and major bleeding are highest during the first weeks of anticoagulation. The CARAVAGGIO trial demonstrated noninferiority of apixaban to dalteparin for treatment of cancer-associated VTE without an increased risk of major bleeding. We compared the early time course of VTE recurrence and major bleeding events of apixaban compared with dalteparin at 7, 30, and 90 days of treatment in patients with cancer-associated VTE. Methods: The study design of the CARAVAGGIO trial has been described. Eligible patients were randomly assigned to receive monotherapy with either apixaban or dalteparin for 6 months. The primary efficacy outcome was the incidence of objectively confirmed recurrent VTE. The primary safety outcome was major bleeding. Results: In 1,155 patients, recurrent VTE after 7, 30, and 90 days occurred in 6 (1%), 15 (2.6%), and 27 (4.7%) patients in the apixaban arm versus 5 (0.9%), 20 (3.5%), and 36 (6.2%) patients respectively in the dalteparin arm. By day 7, 30, and 90, major bleeding events had occurred in 3 (0.5%), 9 (1.6%), and 16 (2.8%) patients in the apixaban group versus 5 (0.9%), 11 (1.9%), and 17 (2.9%) patients in the dalteparin group. Conclusion: The frequencies of recurrent VTE and major bleeding events at 7, 30, and 90 days of apixaban compared with dalteparin were similar in patients with cancer-associated VTE. This supports the use of apixaban for the initiation and early phase of anticoagulant therapy in cancer-associated VTE.
Language	English
Publishing date	2024-01-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	518294-3
ISSN	2567-689X ; 0340-6245
ISSN (online)	2567-689X
ISSN	0340-6245
DOI	10.1055/s-0043-1778642
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Article ; Online: Addendum to British Society for Haematology Guidelines on Investigation and Management of Antiphospholipid syndrome, 2012 (Br. J. Haematol. 2012; 157: 47-58): use of direct acting oral anticoagulants.

Arachchillage, Deepa R J / Gomez, Keith / Alikhan, Raza / Anderson, Julia A M / Lester, Will / Laffan, Mike

British journal of haematology

2020 Volume 189, Issue 2, Page(s) 212–215

MeSH term(s)	Anticoagulants/therapeutic use ; Antiphospholipid Syndrome/diagnosis ; Antiphospholipid Syndrome/drug therapy ; Factor Xa Inhibitors ; Hematology ; Humans
Chemical Substances	Anticoagulants ; Factor Xa Inhibitors
Language	English
Publishing date	2020-01-13
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.16308
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Article ; Online: CHA

Besford, Megan / Leahy, Thomas P / Sammon, Cormac / Ulvestad, Maria / Carroll, Robert / Mehmud, Faisal / Alikhan, Raza / Ramagopalan, Sreeram

Future cardiology

2021 Volume 17, Issue 5, Page(s) 855–864

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Humans ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke
Chemical Substances	Anticoagulants
Language	English
Publishing date	2021-04-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2274267-0
ISSN	1744-8298 ; 1479-6678
ISSN (online)	1744-8298
ISSN	1479-6678
DOI	10.2217/fca-2020-0175
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Article ; Online: SAIL study of stroke, systemic embolism and bleeding outcomes with warfarin anticoagulation in non-valvular atrial fibrillation (S

Harris, Daniel E / Torabi, Fatemeh / Mallory, Daniel / Akbari, Ashley / Thayer, Daniel / Wang, Ting / Grundy, Sarah / Gravenor, Mike / Alikhan, Raza / Lister, Steven / Halcox, Julian

European heart journal open

2023 Volume 3, Issue 3, Page(s) oead037

Abstract: Aims: In patients with non-valvular atrial fibrillation (NVAF) prescribed warfarin, the association between guideline defined international normalised ratio (INR) control and adverse outcomes in unknown. We aimed to (i) determine stroke and systemic ... ...

Abstract	Aims: In patients with non-valvular atrial fibrillation (NVAF) prescribed warfarin, the association between guideline defined international normalised ratio (INR) control and adverse outcomes in unknown. We aimed to (i) determine stroke and systemic embolism (SSE) and bleeding events in NVAF patients prescribed warfarin; and (ii) estimate the increased risk of these adverse events associated with poor INR control in this population. Methods and results: Individual-level population-scale linked patient data were used to investigate the association between INR control and both SSE and bleeding events using (i) the National Institute for Health and Care Excellence (NICE) criteria of poor INR control [time in therapeutic range (TTR) <65%, two INRs <1.5 or two INRs >5 in a 6-month period or any INR >8]. A total of 35 891 patients were included for SSE and 35 035 for bleeding outcome analyses. Mean CHA Conclusion: Guideline-defined poor INR control is associated with significantly higher SSE and bleeding event rates, independent of recognised risk factors for stroke or bleeding.
Language	English
Publishing date	2023-04-13
Publishing country	England
Document type	Journal Article
ISSN	2752-4191
ISSN (online)	2752-4191
DOI	10.1093/ehjopen/oead037
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Article ; Online: Can we collect health-related quality of life information from anticoagulated atrial fibrillation participants who have recently experienced a bleed? An observational feasibility study in primary and secondary care in Wales and through a UK online forum.

Hutchings, Hayley Anne / Lanyon, Kirsty J / Holland, Gail / Alikhan, Raza / Jenkins, Rhys / Laing, Hamish / Hughes, Arfon / Lobban, Trudie / Pollock, Kevin / Tod, Daniel / Lister, Steven

BMJ open

2023 Volume 13, Issue 10, Page(s) e075335

Abstract: Objective: To evaluate the feasibility of recruiting participants diagnosed with atrial fibrillation (AF) taking oral anticoagulation therapies (OATs) and recently experiencing a bleed to collect health-related quality of life (HRQoL) information.: ... ...

Abstract	Objective: To evaluate the feasibility of recruiting participants diagnosed with atrial fibrillation (AF) taking oral anticoagulation therapies (OATs) and recently experiencing a bleed to collect health-related quality of life (HRQoL) information. Design: Observational feasibility study. The study aimed to determine the feasibility of recruiting participants with minor and major bleeds, the most appropriate route for recruitment and the appropriateness of the patient-reported outcome measures (PROMs) selected for collecting HRQoL information in AF patients, and the preferred format of the surveys. Setting: Primary care, secondary care and via an online patient forum. Participants: The study population was adult patients (≥18) with AF taking OATs who had experienced a recent major or minor bleed within the last 4 weeks. Primary and secondary outcome measures: Primary outcomes Results: We received initial expressions of interest from 103 participants. We subsequently recruited 32 participants to the study-14 from primary care and 18 through the AF forum. No participants were recruited through secondary care. Despite 32 participants consenting, only 26 initial surveys were completed. We received follow-up surveys from 11 participants (8 primary care and 3 AF forum). COVID-19 had a major impact on the study. Conclusions: Primary care was the most successful route for recruitment. Most participants recruited to the study experienced a minor bleed. Further ways to recruit in secondary care should be explored, especially to capture more serious bleeds. Trial registration number: The study is registered in the Clinicaltrials.gov database, NCT04921176.
MeSH term(s)	Adult ; Humans ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/diagnosis ; Secondary Care ; Feasibility Studies ; Quality of Life ; Wales ; COVID-19 ; Hemorrhage/diagnosis ; Anticoagulants/therapeutic use
Chemical Substances	Anticoagulants
Language	English
Publishing date	2023-10-06
Publishing country	England
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-075335
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Article ; Online: HIDDEN2: Study protocol for the hospital deep vein thrombosis detection study in patients with cancer receiving palliative care.

Kitson, Terri / Osborne, Emma / Noble, Simon / Pease, Nikki / Alikhan, Raza / Bryant, Catherine / Groves, Tristan / Wallace, Rebecca / Walker, Sarah / Seddon, Kathy / Smith, Deb / Raisanen, Lawrence / Smith, Joanna / Thomas, Ian / Upton, Laura / Casbard, Angela

BMJ open

2023 Volume 13, Issue 9, Page(s) e073049

Abstract: Introduction: Medical patients, admitted acutely to hospital, are at risk of venous thromboembolism (VTE). Clinical guidelines advise thromboprophylaxis prophylaxis for those at high risk of VTE. VTE is a common sequela of cancer, but guidelines take ... ...

Abstract	Introduction: Medical patients, admitted acutely to hospital, are at risk of venous thromboembolism (VTE). Clinical guidelines advise thromboprophylaxis prophylaxis for those at high risk of VTE. VTE is a common sequela of cancer, but guidelines take little consideration of cancer as an independent risk factor and their utility in palliative care patients is unclear. The hospice inpatient deep vein thrombosis (DVT) detection study (HIDDen) reported a 28% prevalence of asymptomatic iliofemoral DVT in hospice patients of poor performance status (PS) and prognosis, calling into question the utility of thromboprophylaxis in the palliative care setting. However, the majority of cancer inpatients receiving palliative care are admitted to hospital through the acute medical setting, yet their risk factors for VTE may differ from those admitted to hospices. Objective: To better understand the prevalence and behaviours of VTE in patients with cancer receiving palliative care who are admitted as an acute medical emergency. Design: Multicentre, observational cohort study. Setting: Secondary care acute hospitals in South Wales, UK. Patients: We plan to recruit 232 patients≥18 years old with a diagnosis of incurable cancer, and/or receiving palliative or best supportive care who are admitted acutely to hospital. Patients will be followed up for a maximum of 6 months following registration. Primary outcome: Presence of lower extremity DVT. Secondary outcomes: Symptom burden attributed to DVT or pulmonary embolism, patient PS, patient demographics and development of new VTE within 90 days of registration. Analysis: The study statistical analysis plan will document analysis, methodology and procedures. Ethics and dissemination: Ethical approval was obtained from the Wales Research Ethics Committee, reference 22/WA/0037 (IRAS 306352)-the main trial results will be analysed as soon as practically possible and the publication shared with investigators and on sponsor website; applications to access trial data will be subject to sponsor review process.
MeSH term(s)	Humans ; Adolescent ; Palliative Care ; Anticoagulants ; Venous Thromboembolism ; Neoplasms ; Inpatients ; Hospices ; Observational Studies as Topic
Chemical Substances	Anticoagulants
Language	English
Publishing date	2023-09-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-073049
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Article: Early Time Courses of Recurrent Venous Thromboembolism and Bleeding during Apixaban or Dalteparin Therapy for Patients with Cancer

Cohen, Alexander T. / Creeper, Katherine J. / Alikhan, Raza / Er, Chaozer / Connors, Jean M. / Huisman, Menno V. / Munoz, Andres / Vescovo, Giorgio / Bauersachs, Rupert / Ageno, Walter / Agnelli, Giancarlo / Becattini, Cecilia

Thrombosis and Haemostasis

2024

Abstract	Background: In patients with acute venous thromboembolism (VTE), the rates of recurrence and major bleeding are highest during the first weeks of anticoagulation. The CARAVAGGIO trial demonstrated noninferiority of apixaban to dalteparin for treatment of cancer-associated VTE without an increased risk of major bleeding. We compared the early time course of VTE recurrence and major bleeding events of apixaban compared with dalteparin at 7, 30, and 90 days of treatment in patients with cancer-associated VTE. Methods: The study design of the CARAVAGGIO trial has been described. Eligible patients were randomly assigned to receive monotherapy with either apixaban or dalteparin for 6 months. The primary efficacy outcome was the incidence of objectively confirmed recurrent VTE. The primary safety outcome was major bleeding. Results: In 1,155 patients, recurrent VTE after 7, 30, and 90 days occurred in 6 (1%), 15 (2.6%), and 27 (4.7%) patients in the apixaban arm versus 5 (0.9%), 20 (3.5%), and 36 (6.2%) patients respectively in the dalteparin arm. By day 7, 30, and 90, major bleeding events had occurred in 3 (0.5%), 9 (1.6%), and 16 (2.8%) patients in the apixaban group versus 5 (0.9%), 11 (1.9%), and 17 (2.9%) patients in the dalteparin group. Conclusion: The frequencies of recurrent VTE and major bleeding events at 7, 30, and 90 days of apixaban compared with dalteparin were similar in patients with cancer-associated VTE. This supports the use of apixaban for the initiation and early phase of anticoagulant therapy in cancer-associated VTE.
Keywords	anticoagulants ; bleeding ; cancer ; dalteparin ; thrombosis
Language	English
Publishing date	2024-01-09
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	518294-3
ISSN	2567-689X ; 0340-6245
ISSN (online)	2567-689X
ISSN	0340-6245
DOI	10.1055/s-0043-1778642
Database	Thieme publisher's database

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