Key result
Review evaluates DOACs versus LMWH for VTE treatment and prophylaxis in cancer patients.
Why the study?
DOACs are an alternative to LMWH in cancer patients, but clinicians face challenging decisions regarding contraindications, incidental VTE, specific cancer types, drug interactions, and thromboprophylaxis.
What are the practical solutions and challenges for using DOACs versus LMWH for VTE treatment and prophylaxis in cancer patients?
What are the practical solutions and challenges for using DOACs versus LMWH for VTE treatment and prophylaxis in cancer patients?
This review provides practical guidance on the use of DOACs for VTE management in cancer patients, addressing specific clinical challenges such as bleeding risks and drug interactions.
May guide DOAC selection in cancer VTE with caution; leaves open need for targeted RCTs on bleeding risks.
The direct-acting oral anticoagulant (DOAC) has become an alternative to low-molecular-weight heparin (LMWH) for treatment and prophylaxis of venous thromboembolism (VTE) in cancer patients. The clinicians are, however, faced with difficult decisions regarding DOAC treatment: Which patients cannot use DOACs? Should incidental VTE be treated similar to symptomatic VTE? Is it safe to give DOACs to patients with gastrointestinal or urogenital cancers? How about drug-drug interactions? Should all cancer patients receive thromboprophylaxis? Is arterial thrombosis a problem? The current article reviews the available literature regarding these questions and aims to provide practical solutions based on data from the clinical trials and new guidelines.
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Anders Erik Astrup Dahm (2021) conducted a review in Venous thromboembolism in cancer patients. Direct-acting oral anticoagulants (DOACs) vs. Low-molecular-weight heparin (LMWH) was evaluated. This review discusses the use of direct-acting oral anticoagulants compared to low-molecular-weight heparin for the treatment and prophylaxis of venous thromboembolism in cancer patients.
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