癌症相关血栓形成 (CAT) 患者管理中的一个主要问题是抗凝剂和抗癌疗法之间的药物相互作用 (DDI)。它们的临床意义尚不清楚。为了量化接受抗凝治疗的 CAT 患者的 DDI 患病率以及复发性静脉血栓栓塞 (VTE) 和出血事件的风险，我们对同时接受抗凝治疗和抗癌和/或支持治疗的 CAT 患者进行了一项回顾性队列研究护理疗法。所有患者从 CAT 诊断起或直至死亡（以先发生者为准）均接受 6 个月的随访。主要结局是 6 个月内任何时间 Lexicomp® 中被归类为风险 C、D 或 X 的抗凝 DDI 患者的百分比。次要结局包括复发性 VTE 和临床相关出血事件。我们以 95% 置信区间 (CI) 计算结果的 6 个月累积发生率，并比较使用和不使用 DDI 的患者，将死亡视为竞争风险。在纳入的 267 名患者中，111 名 (41.6%) 曾在任何时间接受过使用抗凝剂的 DDI在学习期间。与 LMWH 相比，任何时候服用 DOAC 的人都有更多的 DDI（50.9% vs 19.3%，p < 0.0001）。复发性 VTE 的 6 个月发生率为 8.2% (95% CI 5.3-11.9)，临床相关出血的 6 个月发生率为 6.7% (95% CI 4.2-10.2)，有或没有 DDI 的组之间没有显着差异。接受抗凝治疗的 CAT 患者中 DDI 的比例，更多的是使用 DOAC 的比例。 Lexicomp® 分类为 C、D 或 X 风险的 DDI 与我们队列中的复发性 VTE 或出血事件无关。版权所有 © 2023 Elsevier Ltd。保留所有权利。

A main concern in the management of patients with cancer-associated thrombosis (CAT) is drug-drug interactions (DDIs) between anticoagulants and anticancer therapies. Their clinical implications remain unclear.To quantify the prevalence of DDIs and risks of recurrent venous thromboembolism (VTE) and bleeding events in patients with CAT on anticoagulation, we conducted a retrospective cohort study in patients with CAT on concurrent anticoagulants and anticancer and/or supportive care therapies. All patients were followed for 6 months from CAT diagnosis or until death (whichever occurred first). The primary outcome was the percentage of patients with anticoagulant DDIs classified as risk C, D, or X in Lexicomp® at any time during the 6 months. Secondary outcomes included recurrent VTE and clinically relevant bleeding events. We calculated the 6-month cumulative incidence of outcomes with 95 % confidence interval (CI) and compared those with and without DDIs, considering death as a competing risk.Among 267 patients included, 111 (41.6 %) had DDIs with anticoagulants at any time during the study. Those on DOACs at any time had more DDIs compared to LMWH (50.9 % vs 19.3 %, p < 0.0001). The 6-month incidence was 8.2 % (95 % CI 5.3-11.9) for recurrent VTE and 6.7 % (95 % CI 4.2-10.2) for clinically relevant bleeding, with no significant differences between groups with or without DDIs.There are high incidences of DDIs in patients with CAT on anticoagulants, more with DOACs. DDIs classified as risk C, D, or X by Lexicomp® were not associated with recurrent VTE or bleeding events in our cohort.Copyright © 2023 Elsevier Ltd. All rights reserved.