VTE guidelines
Traditionally, anticoagulants used to treat signs and symptoms of VTE have included LMWH or vitamin K antagonists (VKAs).
More recently, DOACs, have emerged as a potential option for pharmacologic thromboprophylaxis and for treatment of patients with cancer at risk or at high risk of VTE1.
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LMWH has remained the standard treatment for cancer-associated VTE.
However, with the increased use of DOACs, three recent randomised controlled trials have been conducted to compare the safety and efficacy of DOACs with LMWH3.
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Most hospitalised patients with cancer and an acute medical condition require thromboprophylaxis throughout hospitalisation.
Thromboprophylaxis is not routinely recommended for all outpatients with cancer12.
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References
1, Patel, T. & Iglesias, D. A. Venous Thromboembolism Treatment and Prevention in Cancer Patients: Can We Use Pills Yet? Current Treatment Options in Oncology 2020;21:43
2. Ramacciotti, E. et al. Direct Oral Anticoagulants and Cancer-Associated Thrombosis Management. Where Do We Stand in 2019? Clinical and Applied Thrombosis/Hemostasis 2019;25
3. Treatment of Malignancy Associated Venous Thromboembolism - American College of Cardiology. Available at: https://www.acc.org/latest-in-cardiology/articles/2020/05/05/08/31/treatment-of-malignancy-associated-venous-thromboembolism (accessed 18 September 2020)
4. Lee, A. Y. Y. et al. Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: A randomized clinical trial. JAMA - J. Am. Med. Assoc. 2015;314:677–686
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