Treatment of cancer associated thrombosis

"Treatment of cancer associated thrombosis The treatment of cancer-associated venous thromboembolic disease is complex due to an increased risk of thrombotic recurrence and bleeding under treatment. During the first 6 months, low molecular weight heparins are more effective than vitamin k antagonists without increasing the risk of bleeding. Direct oral anticoagulants (doacs) have at least comparable efficacy to delateparin. The hemorrhagic risk of doacs is comparable or higher than that of dalteparin, but seems to depend on the doac studied and, at least for some of them, on the location of the tumor. Beyond the 6th month, the cura-tive anticoagulant treatment is continued as long as the cancer is active with low molecular weight heparin if it is well tolerated and effective or by using a doac at full dose while waiting for the results of a randomized trial comparing the efficacy and safety of half-dose versus full-dose of apixaban." "Traitement de la maladie thromboembolique veineuse associée au cancer Le traitement de la maladie thromboembolique veineuse associée au cancer est plus complexe du ait de l’augmentation du risque de récidive thrombotique et d’hémorragie sous traitement. Au cours des six premiers mois, les héparines de bas poids moléculaire sont plus efficaces que les antivitamine-k sans augmentation du risque hémorragique. Versus la daltéparine, l’efficacité des anticoagulants oraux directs (aod) est au moins comparable. Le risque hémorragique lié aux aod est comparable ou supérieur à celui de la daltéparine, mais semble dépendre de l’aod étudié et, au moins pour certains d’entre eux, de la localisation de la maladie tumorale. Au-delà du sixième mois, le traitement anticoagulant curatif est poursuivi tant que le cancer est actif, avec l’héparine de bas poids moléculaire si elle est bien tolérée et efficace, ou un anticoagulant oral direct à pleine dose, en attendant les résultats d’un essai randomisé en cours comparant l’efficacité et la tolérance de l’apixaban à demi-dose et à pleine dose."

Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.

El resumen se deja sin traducir para conservar la redacción original de los autores.

This review summarizes anticoagulant therapy for cancer-associated venous thromboembolism, noting low molecular weight heparins outperform vitamin K antagonists during the first six months and direct oral anticoagulants show at least comparable efficacy to dalteparin with tumor-dependent bleeding risk.

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