The role of direct oral anticoagulants in the treatment of cancer associated venous thromboembolism Review article
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Abstract
Cancer disease is one of the most significant risk factors for venous thromboembolic complications. In this review features of treatment and unsolved questions of alternative anticoagulant therapy of cancer- associated thromboembolism (CAT) are considered. The modern guidelines advocate the use of low-molecular-weight heparin (LMWH) over a vitamin K antagonist (VKA) for the first 3–6 months after diagnosis of VTE in cancer patients. Few years ago direct oral anticoagulants (DOACs) have been approved for the treatment of venous thromboembolism (VTE). DOACs have demonstrated comparable efficacy and safety with VKA in general population. But efficacy and safety of DOACs as compared with long-term LMWH for the treatment of CAT have not been definitely established. The review focuses on the results of the first two prospective randomized studies (HOKUSAI VTE Cancer and SELECT-D) in which the efficacy and safety of edoxaban and rivaroxaban was compared with low-molecular-weight heparin dalteparin for the treatment of VTE in cancer patients and the latest recommendations from SSC of the ISTH on the feasibility of using DOACs in the treatment of CAT.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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