Annals for Hospitalists Inpatient Notes - Direct Oral Anticoagulants in Patients With Cancer—What Hospitalists Need to Know

Web ExclusivesApril 2021Annals for Hospitalists Inpatient Notes - Direct Oral Anticoagulants in Patients With Cancer—What Hospitalists Need to KnowAgnes Y.Y. Lee, MD, MScAgnes Y.Y. Lee, MD, MScUniversity of British Columbia, BC Cancer, and Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada (A.Y.Y.L.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-0807 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail During the past decade, direct oral anticoagulants (DOACs) have emerged as the new standard of care in the treatment of venous thromboembolism (VTE). Clinical trials and real-world data have shown that these agents are more convenient and safer than traditional treatment with a parenteral heparin followed by warfarin therapy. However, in patients with cancer who have a high risk for thrombosis and bleeding and a greater potential for drug–drug interactions and gastrointestinal complications, the use of DOACs can be challenging.For many years, low-molecular-weight heparin (LMWH) has been the anticoagulant of choice for the treatment of cancer-associated thrombosis (CAT) (1). ...References1. Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2020;38:496-520. [PMID: 31381464] doi:10.1200/JCO.19.01461 CrossrefMedlineGoogle Scholar2. Mulder FI, Bosch FTM, Young AM, et al. Direct oral anticoagulants for cancer-associated venous thromboembolism: a systematic review and meta-analysis. Blood. 2020;136:1433-1441. [PMID: 32396939] doi:10.1182/blood.2020005819 CrossrefMedlineGoogle Scholar3. Martin KA, Lee CR, Farrell TM, et al. Oral anticoagulant use after bariatric surgery: a literature review and clinical guidance. Am J Med. 2017;130:517-524. [PMID: 28159600] doi:10.1016/j.amjmed.2016.12.033 CrossrefMedlineGoogle Scholar4. Samuelson Bannow BT, Lee A, Khorana AA, et al. Management of cancer-associated thrombosis in patients with thrombocytopenia: guidance from the SSC of the ISTH. J Thromb Haemost. 2018;16:1246-1249. [PMID: 29737593] doi:10.1111/jth.14015 CrossrefMedlineGoogle Scholar5. Short NJ, Connors JM. New oral anticoagulants and the cancer patient. Oncologist. 2014;19:82-93. [PMID: 24319019] doi:10.1634/theoncologist.2013-0239 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of British Columbia, BC Cancer, and Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada (A.Y.Y.L.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-0807.Corresponding Author: Agnes Y.Y. Lee, MD, MSc, Diamond Health Care Centre, 2775 Laurel Street, 10th Floor, Vancouver, BC V5Z 1M9, Canada; e-mail, [email protected]bc.ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - April 2021 David H. Wesorick , Jawad Al-Khafaji , and Matthew Luzum Metrics April 2021Volume 174, Issue 4Page: HO2-HO3KeywordsAnticoagulantsApixabanBloodCancer risk factorsCancer treatmentDrugsHemorrhageLow molecular weight heparinRandomized trialsThrombosis ePublished: 20 April 2021 Issue Published: April 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...