Direct Oral Anticoagulants for the Treatment of Cancer-Associated Venous Thromboembolism: A Latin American Perspective

被引：8

作者：

Athanazio, Rodrigo Abensur ^{[1
]}

Ceresetto, Jose Manuel ^{[2
]}

Marfil Rivera, Luis Javier ^{[3
]}

Cesarman-Maus, Gabriela ^{[4
]}

Galvez, Kenny ^{[5
]}

Marques, Marcos Areas ^{[6
]}

Tabares, Aldo Hugo ^{[7
]}

Ortiz Santacruz, Carlos Alberto ^{[8
]}

Santini, Fernando Costa ^{[9
]}

Corrales, Luis ^{[10
]}

Cohen, Alexander T. ^{[11
]}

机构：

[1] Fac Med Sao Paulo, Pulm Div, Heart Inst InCor, Hosp Clin, Av Dr Eneas de Carvalho Aguiar,44-5 Andar Pneumol, BR-05403900 Sao Paulo, SP, Brazil

[2] British Hosp Buenos Aires, Haematol Dept, Buenos Aires, DF, Argentina

[3] Univ Autonoma Nuevo Leon, Hosp Univ Dr Jose E Gonzalez, Serv Hematol, Monterrey, Mexico

[4] Inst Nacl Cancerol, Hematol Dept, Mexico City, DF, Mexico

[5] Hosp Pablo Tobon Uribe, Canc Unit, Medellin, Colombia

[6] Univ Estado Rio de Janeiro, Unit Angiol, Rio De Janeiro, Brazil

[7] Inst Univ Ciencias Biomed Cordoba IUCBC, Vasc Med & Thrombosis Serv, Cordoba, Argentina

[8] Clin Oncol Unit, Clin Country, Bogota, Colombia

[9] Mem Sloan Kettering Canc Ctr, Thorac Oncol Serv, New York, NY USA

[10] Ctr Invest & Manejo Canc CIMCA, Med Oncol, San Jose, Costa Rica

[11] Kings Coll London, Dept Haematol Med, Guys & St Thomas Hosp NHS Fdn Trust, London, England

来源：

CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS | 2022年 / 28卷

关键词：

anticoagulation; cancer; venous thromboembolism; MOLECULAR-WEIGHT HEPARIN; PROSPECTIVE COHORT; ACTIVE CANCER; WARFARIN; VTE; APIXABAN; METAANALYSIS; RIVAROXABAN; PREVENTION; DALTEPARIN;

D O I：

10.1177/10760296221082988

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in patients with cancer. On the basis of results from randomized controlled trials, direct oral anticoagulants (DOACs) are now recommended for the treatment of cancer-associated VTE. The decision to use a DOAC requires consideration of bleeding risk, particularly in patients with gastrointestinal (GI) malignancies, the cost-benefit and convenience of oral therapy, and patient preference. While efficacy with apixaban, edoxaban, and rivaroxaban versus dalteparin has been consistent in the treatment of cancer-associated VTE, heterogeneity is evident with respect to major GI bleeding, with an increased risk with edoxaban and rivaroxaban but not apixaban. Although cost and accessibility vary in different countries of Latin America, DOACs should be considered for the long-term treatment of cancer-associated VTE in all patients who are likely to benefit. Apixaban may be the preferred DOAC in patients with GI malignancies and LMWH may be preferred for patients with upper or unresected lower GI tumors. Vitamin K antagonists should only be used for anticoagulation when DOACs and low molecular weight heparin are inaccessible or unsuitable.

引用

页数：13