Supportive Therapy in OncologySupportive Therapy in OncologyПоддерживающая терапия в онкологии3034-24733034-3178Publishing House ABV Press5310.17650/3034-2473-2025-2-1-58-65CLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙApixaban for the treatment and secondary prevention of thrombotic complications in cancer patients with impaired renal functionАпиксабан для лечения и вторичной профилактики тромботических осложнений у онкологических пациентов с нарушением функции почекhttps://orcid.org/0000-0003-4706-2439SomonovaO. V.СомоноваО. В.
Russian Federation

Oxana Vasilyevna Somonova 

24 Kashirskoe Shosse, Moscow 115522 

Оксана Васильевна Сомонова 

115522 Москва, Каширское шоссе, 24 

somonova@mail.ruhttps://orcid.org/0000-0002-4633-8301GromovaE. G.ГромоваЕ. Г.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522 

115522 Москва, Каширское шоссе, 24 

https://orcid.org/0000-0001-6975-4562ElizarovaA. L.ЕлизароваА. Л.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522 

115522 Москва, Каширское шоссе, 24 

https://orcid.org/0000-0001-9285-3470BabkinaI. V.БабкинаИ. В.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522 

115522 Москва, Каширское шоссе, 24 

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России150420252158650704202507042025Copyright ©; 2025, Somonova O.V., Gromova E.G., Elizarova A.L., Babkina I.V.Copyright ©; 2025, Сомонова О.В., Громова Е.Г., Елизарова А.Л., Бабкина И.В.2025Somonova O.V., Gromova E.G., Elizarova A.L., Babkina I.V.Сомонова О.В., Громова Е.Г., Елизарова А.Л., Бабкина И.В.https://creativecommons.org/licenses/by/4.0https://stio.abvpress.ru/jour/article/view/53

Malignant neoplasms are associated with a high risk of venous thromboembolic complications (VTEC), which worsen antitumor treatment and are the second leading cause of death after cancer progression. In patients with comorbid pathology, the risk of bleeding increases, especially during antithrombotic therapy. With a decrease in kidney function, the risk of bleeding increases 3-fold. To assess the possibilities of prescribing anticoagulant therapy to cancer patients with venous thrombosis and chronic kidney disease, a clinical observation is given.The article presents a case of a patient with breast cancer and chronic kidney disease. For the treatment and secondary prevention of deep vein thrombosis of the lower extremities, a patient received apixaban (Eliquis), which prevented the risk of recurrent venous thrombosis without increasing the risk of bleeding. Large randomized trials have shown the efficacy and safety of apixaban in the treatment and secondary prevention of VTEC in cancer patients, including patients with chronic kidney disease. According to the results of real clinical practice, apixaban was superior to standard therapy (low molecular weight heparin + vitamin K antagonists) in both efficacy and safety in the treatment and prevention of recurrent VTEC. Thus, the anticoagulant apixaban is one of the effective and safe factor Xa inhibitors, which is characterized by a rapid onset of action and predictable pharmacokinetics; it can be considered as an affordable and effective method for the treatment and prevention of recurrent VTEC, improving the quality of life and increasing the life expectancy of cancer patients.

Злокачественные новообразования ассоциированы с высоким риском развития венозных тромбоэмболических осложнений (ВТЭО), которые ухудшают противоопухолевое лечение и занимают 2-е место среди причин смерти после прогрессирования онкологического заболевания. У пациентов с коморбидной патологией повышается риск кровотечения, особенно во время проведения антитромботической терапии. При снижении функции почек риск кровотечений увеличивается в 3 раза. Для оценки возможности назначения антикоагулянтной терапии онкологическим пациентам с венозным тромбозом и хронической болезнью почек приводится клиническое наблюдение.В статье представлен случай пациентки с диагнозом рака молочной железы и хронической болезнью почек. Для лечения и вторичной профилактики тромбоза глубоких вен нижних конечностей пациентка получала апиксабан (Эликвис), который предотвратил риск развития рецидива венозного тромбоза без увеличения риска кровотечения. Крупные рандомизированные исследования продемонстрировали эффективность и безопасность апиксабана в лечении и вторичной профилактике ВТЭО у онкологических пациентов, в том числе пациентов с хронической болезнью почек. Анализ результатов применения препарата в реальной клинической практике показал, что апиксабан превосходил стандартную терапию (низкомолекулярный гепарин + антагонисты витамина K) как по эффективности, так и по безопасности при лечении и профилактике рецидивов ВТЭО. Таким образом, антикоагулянт апиксабан – один из эффективных и безопасных ингибиторов фактора Ха, который характеризуется быстрым началом действия, предсказуемой фармакокинетикой и может рассматриваться в качестве доступного и эффективного способа лечения и профилактики рецидивов ВТЭО, улучшения качества и увеличения продолжительности жизни онкологических пациентов.

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