Key result
DOACs show no difference versus standard therapy for VTE recurrence and bleeding in cancer patients.
Why the study?
Patients with cancer have an elevated risk of VTE, and while LMWH and warfarin are standard therapies, DOACs are increasingly used, requiring comparative safety and efficacy assessment.
Do direct oral anticoagulants reduce VTE recurrence compared to standard therapy (LMWH and warfarin) in patients with cancer-associated VTE?
Comparison
Apixaban vs edoxaban vs rivaroxaban vs LMWH vs warfarin
Design
Systematic review and Bayesian network meta-analysis of randomized controlled trials
Authors
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Comparable VTE outcomes with DOACs versus standard therapy in cancer; wide credible intervals leave optimal agent selection open.
Meta-Analysis (n=3,325)
Do direct oral anticoagulants reduce VTE recurrence compared to standard therapy (LMWH and warfarin) in patients with cancer-associated VTE?
Odds Ratio: 0.51 (95% CI 0.1–2.66)
A network meta-analysis found no statistically significant differences in efficacy or safety between DOACs, LMWH, and warfarin for cancer-associated VTE, though wide credible intervals limit precision.
Shahbar et al. (2026) conducted a meta-analysis in Cancer-associated venous thromboembolism (n=3,325). Direct oral anticoagulants (apixaban, edoxaban, rivaroxaban) vs. Standard therapy (low-molecular-weight heparin and warfarin) was evaluated on VTE recurrence (OR 0.51, 95% CI 0.10-2.66). Direct oral anticoagulants showed no statistically significant difference in VTE recurrence compared to standard therapy in cancer patients (e.g., rivaroxaban vs LMWH OR 0.51; 95% CrI 0.10-2.66).
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