Key result
Direct oral anticoagulants are an effective alternative to low-molecular-weight heparin for treating cancer-associated venous thromboembolism, though they may increase major bleeding in GI cancers.
Why the study?
DOACs offer advantages over low-molecular-weight heparin for treating venous thromboembolic disease, but comparative long-term efficacy and safety data in patients with cancer have been limited.
Do direct oral anticoagulants (DOACs) reduce venous thromboembolism recurrence and prevent VTE in patients with cancer compared to low-molecular-weight heparin or placebo?
Do direct oral anticoagulants (DOACs) reduce venous thromboembolism recurrence and prevent VTE in patients with cancer compared to low-molecular-weight heparin or placebo?
DOACs offer an effective oral alternative to LMWH for managing cancer-associated thrombosis, though caution is needed regarding bleeding risk in patients with gastrointestinal malignancies.
Supports DOAC preference over LMWH for most cancer-associated VTE with GI bleeding caution; confirms pooled RCT efficacy and safety in systematic synthesis.
Venous thromboembolic disease (VTED) is a common and clinically important complication in patients with cancer, contributing to its mortality and morbidity. Direct oral anticoagulant agents (DOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, are as effective as vitamin K antagonists for the treatment of VTED and are associated with less frequent and severe bleeding. They have advantages over low-molecular-weight heparin, but comparative long-term efficacy and safety data are lacking for these compounds. Recent randomized clinical trials suggest a role for DOACs in the treatment of VTED in patients with cancer. This review will discuss the existing evidence and future perspectives on the role of DOACs in the treatment of VTE based on the current evidence about their overall efficacy and safety and the limited information in patients with cancer; in addition, we will briefly review their pharmacokinetic properties with special reference to potential interactions.
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Escobar et al. (2020) conducted a review in Cancer-associated venous thromboembolism (VTE). Direct oral anticoagulants (DOACs) vs. Low-molecular-weight heparin (LMWH) was evaluated. Direct oral anticoagulants are an effective alternative to low-molecular-weight heparin for treating cancer-associated venous thromboembolism, though they may increase major bleeding in GI cancers.
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