Evaluation of direct oral anticoagulants for the treatment of cancer-associated thrombosis: an update
| Autor: | M. Palka-Kotlowsa, L. Cabezón-Gutiérrez, M. Villamayor-Delgado, A. Franco-Moreno, M. García-Navarro |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Vitamin K medicine.drug_class Low molecular weight heparin 030204 cardiovascular system & hematology Dabigatran 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Edoxaban Internal medicine Neoplasms medicine Humans 030212 general & internal medicine Randomized Controlled Trials as Topic Rivaroxaban business.industry Anticoagulants Thrombosis Hematology Venous Thromboembolism Heparin Low-Molecular-Weight medicine.disease chemistry Direct thrombin inhibitor Hormonal therapy Apixaban Cardiology and Cardiovascular Medicine business medicine.drug Factor Xa Inhibitors |
| Zdroj: | Journal of thrombosis and thrombolysis. 47(3) |
| ISSN: | 1573-742X |
| Popis: | Cancer is associated with an increased risk of venous thromboembolism of four to sixfold. Cancer-related interventions such as chemotherapy, hormonal therapy and indwelling central venous catheters also increase the risk of venous thromboembolism. Low molecular weight heparin for at least 3–6 months is the current standard of care for the treatment of cancer associated venous thromboembolism. Anticoagulation should be continued as long as the cancer is active. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In the randomized controlled trials comparing direct oral anticoagulants with vitamin K antagonists, the direct oral anticoagulants all provide non-inferior in prevention of thromboembolic events in patients with atrial fibrillation, for the prevention and treatment of venous thromboembolism and in acute coronary syndrome. In people with cancer, these drugs have emerged as attractive alternatives for the treatment of venous thromboembolism with the potential to overcome the limitations of low molecular weight heparin. Randomized controlled studies comparing direct oral anticoagulants to low molecular weight heparin in cancer patients are still limited and direct oral anticoagulants are not recommended for the treatment of cancer associated venous thromboembolism yet. However, new emerging data are supporting the use of direct oral anticoagulants in cancer-associated thrombosis. Here, we review recent data on the evidence related to the efficacy and safety of direct oral anticoagulants for the treatment of venous thromboembolism in patients with cancer. |
| Databáze: | OpenAIRE |
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