New Direct Oral Anticoagulants for Cancer-Associated VTE: How Effective?

For treating venous thromboembolism (VTE) in patients with active cancer, guidelines from the American College of Chest Physicians express a preference for low-molecular-weight heparin over vitamin K antagonists (Chest 2012; 141(2 Suppl):e419S); however, this recommendation is graded 2B (weak recommendation, moderate-quality evidence). Now, researchers have conducted a meta-analysis to determine the efficacy of the new direct oral anticoagulants (DOACs; dabigatran [Pradaxa], rivaroxaban [Xarelto], apixaban [Eliquis], and edoxaban [Savaysa]) in such patients.

In six studies of patients with VTE who received vitamin K antagonists (usually warfarin) or DOACs, researchers specifically reported results for subgroups of patients with active cancer…