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The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients

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Last updated:1st Oct 2019
Status: Live
The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients: Guidance from the SSC of the ISTH


Venous thromboembolism (VTE) is a major complication in cancer patients. The Scientific and Standardization Committee through its subcommittee Hemostasis & Malignancy of the International Society for Thrombosis and Hemostasis (ISTH) aims to review emerging data on primary VTE prophylaxis with direct oral anticoagulants (DOACs) for ambulatory cancer patients and provide guidance to clinicians. A guidance document was previously published focusing on using low‐molecular‐weight heparin (LMWH) for VTE prophylaxis in ambulatory cancer patients. Individualized patient care after mutual discussion and decision making with patients remains important. Three guidance statements are included in this document. Recommendations reflect strong guidance statements supported by evidence from clinical trials. Suggestions reflect weaker guidance statements based on expert opinions and best available evidence.

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