Warfarin Does Not Prevent Catheter-Related Thromboses in Patients with Cancer

Warfarin does not lower the risk for catheter-related thromboses in patients with cancer, Lancet reports.

15 feb 2009--In a multicenter trial, nearly 1600 patients receiving chemotherapy through central venous catheters were randomized to receive fixed-dose warfarin (1 mg/day), dose-adjusted warfarin (international normalized ratio goal: 1.5–2.0), or no warfarin.

Overall, 5% of patients developed radiologically confirmed catheter-related thromboses. The rate did not differ between patients receiving warfarin and those not on the drug. Similarly, warfarin did not reduce the rate of non-catheter-related thromboses.

The authors conclude that "the time has come to move on from warfarin for thromboprophylaxis in patients with cancer." A commentator generally agrees, but notes that individual treatment decisions should be based on "the personal and familial history of the patient, the carriage of thrombophilia, the presence of comorbidities, and the patient's preference."

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Lancet article (Free abstract; full text requires subscription)