Comparative Study of Tinzaparin to Warfarin Yields Mixed Findings

Clinical practice guidelines often encourage the use of tinzaparin over warfarin to treat venous thromboembolism (VTE), with this recommendation based on findings from a single study and supportive evidence from smaller trials that were conducted over a decade ago. However, the results of a more recent study suggest that tinzaparin may only offer limited benefits over its alternative.

The study, published in the Journal of the American Medical Association, randomly assigned 900 adult patients with active cancer and documented VTE to receive either tinzaparin or warfarin for 6 months. After a 180-day follow-up period, the research team determined that the use of tinzaparin did not significantly reduce recurrent VTE compared with warfarin, with the condition occurring in 31 of 449 tinzaparin-treated patients and 45 of 451 warfarin-treated participants. The researchers also found that there were no statistically significant differences in major bleeding or overall mortality between the 2 drugs. Tinzaparin did, however, considerably reduce the risk of clinically relevant nonmajor bleeding compared with its alternative. Additionally, the study authors affirmed that the drug’s safety profile establishes it as an appropriate VTE treatment in cancer patients.

“Together with the adverseevents data, [this trial] demonstrated that tinzaparin, even when given at a full therapeutic dose for up to 6 months, is safe in a broad oncology population,” the authors wrote. The researchers noted that further studies are needed to establish the drugs’ efficacy outcomes in patients at higher risk of recurrent VTE.