Direct oral anticoagulants are noninferior to low-molecular-weight heparin to prevent recurrent VTE in adults with cancer

Clinical Question

Are direct oral anticoagulants noninferior to low-molecular-weight heparin for preventing recurrent venous thromboembolism in adults with cancer?

Bottom line

This study found DOACs to be noninferior to LMWH for preventing recurrent VTE over a 6-month follow-up in adults with cancer. Severe adverse events, including major bleeding, occurred similarly in both groups. Outcomes remained similar regardless of specific cancer thrombogenic risk. Patients given DOACs were significantly more likely to still be taking their assigned anticoagulant at 6 months, suggesting a superior outcome with DOACs with longer follow-up. 1b-

Study design: Randomized controlled trial (single-blinded)

Funding: Government

Setting: Outpatient (any)

Reviewer

David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC


Discuss this POEM


Comments

Anonymous

DOC's non inferior

Good to know

ARUP KUMAR DHARA

Impact assessment

Excellent

Anonymous

No

No comment.

Anonymous

ORAL ANTICOAGULANT AND LOW MOLICULAR HEPARIN

GOOD TO KNOW

Anonymous

Sex-disaggregated data

I am curious as to the difference in reaction of men and women with DOACs vs LMWH since we know that men and women have different risk factors for VTE at different ages (as well as different reaction/efficacy of anti-coagulants). Any comment?