Are DOACs Better Than LMWH for Treating Venous Thromboembolism in Cancer Patients?

A meta-analysis reveals that direct-acting oral anticoagulants better manage recurrent VTE, whereas low-molecular-weight heparins confer less bleeding risk.

In two recent large trials, researchers evaluated use of direct-acting oral anticoagulants (DOACs) for managing venous thromboembolism (VTE) in patients with active cancer (NEJM JW Gen Med Mar 1 2018 and N Engl J Med 2018; 378:615; NEJM JW Gen Med Aug 15 2018 and J Clin Oncol 2018; 36:2017). Now, investigators have performed a meta-analysis of data from >4600 patients in 14 randomized trials to evaluate the efficacy and safety of various anticoagulant classes — DOACs, low-molecular-weight heparin (LMWH), and warfarin — for managing patients with VTE and active cancer.

In direct comparisons of drug classes, DOACs were significantly more effective than LMWH in preventing VTE recurrence (risk difference, 3.8%; number needed to treat [NNT], 24),…

Reviewing Authors

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Mikhail Akbashev, MD

Are DOACs Better Than LMWH for Treating Venous Thromboembolism in Cancer Patients?

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Reviewing Authors