Direct-Acting Oral Anticoagulants May be an Option for Cancer-Associated Venous Thromboembolism
Direct-acting oral anticoagulants appear to be an option for some patients with cancer and venous thromboembolism, but studies are still ongoing, according to a paper published online in the journal Thrombosis Research.
“Approximately one-fifth of all cases of venous thromboembolism are related to cancer and anticoagulant treatment in these patients has remained a challenge,” wrote study lead author Maria Cristina Vedovati, MD, of the University of Perugia in Italy, and colleagues. “Cancer patients with venous thromboembolism are at increased risk of developing recurrent venous thromboembolism compared to patients without cancer, but also have a higher risk of major bleeding.”
While most clinical guidelines recommend low-molecular-weight heparin for cancer-associated venous thromboembolism, direct-acting anticoagulants have become the standard for venous thromboembolism treatment in the general population, researchers explained.
“Because direct-acting anticoagulants offer a simple oral treatment regimen without the need for anticoagulation control, they could be an attractive alternative to low-molecular-weight heparin,” the authors noted.
After reviewing data from two randomized trials that compared direct-acting anticoagulants with low molecular weight heparins, Dr Vedovati and colleagues reported that data appear to suggest direct-acting anticoagulants may be used in patients with cancer-associated venous thromboembolism at low risk of bleeding.
However, “the management of patients with cancer at high risk of bleeding, such as those with gastrointestinal and genitourinary disease, should require particular attention, and low molecular weight heparin may be preferred,” the authors wrote.—Jolynn Tumolo
Reference:
Vedovati MC, Giustozzi M, Becattini C. Venous thromboembolism and cancer: current and future role of direct-acting oral anticoagulants. Thrombosis Research. 2019 February 27;[Epub ahead of print].
