Use of Direct Oral Anticoagulants in Elderly Patients with Cancer

Venous thromboembolism is a common complication in elderly patients, especially in the presence of cancer. Currently used for thromboprophylaxis, vitamin K antagonists and low molecular weight heparins are effective, but have a number of disadvantages, which leads to a rare prescription of anticoagulant therapy in elderly patients. Modern studies have shown that direct oral anticoagulants (DOACs) can also be effective and safe in this category of patients, and the convenience of their use increases patient adherence to treatment. However, elderly patients have a number of features that must be considered when prescribing anticoagulant therapy. So, in the presence of renal failure or impaired liver function, it is necessary to consider the possibility of adjusting the prescribed dose. And in connection with the polypharmacy common in old age and the drug interactions associated with it, it is necessary to carefully consider all the drugs taken by the patient for their compatibility and, if necessary, make replacements. This review presents data on the efficacy and safety of DOACs in elderly patients, as well as presents and systematizes various clinical situations when therapy correction or careful monitoring is required.