The role of direct oral anticoagulants in the treatment of cancer associated venous thromboembolism
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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.
- Department of Clinical Problem of Atherothrombosis, A.L. Myasnikov Institute Cardiology National Medical Research Center of Cardiology of Ministry of Health of the Russian Federation, firstname.lastname@example.org
- Department of Clinical Problem of Atherothrombosis, A.L. Myasnikov Institute Cardiology National Medical Research Center of Cardiology of Ministry of Health of the Russian Federation, email@example.com
- Department of Clinical Problem of Atherothrombosis, A.L. Myasnikov Institute Cardiology National Medical Research Center of Cardiology of Ministry of Health of the Russian Federation
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