Direct oral anticoagulants for the treatment of acute venous thromboembolism in patients with cancer: a meta-analysis of randomised controlled trials

What is it about?

Pooling together 6 randomized controlled studies reporting data on safety and efficacy of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKA) in 27,178 patients with cancer-related venous thromboembolism (VTE), we found that DOACs were more effective than VKA in patients with active cancer in preventing recurrent VTE and as effective as VKA in patients with a history of cancer and in patients without cancer. The incidence of major bleeding was lower in the DOAC group than in the VKA group in patients without cancer, but not in patients with active cancer or with history of cancer. Results of this meta-analysis suggest a favorable risk-benefit ratio with the use of DOACs as compared to VKA in patients with active-cancer-related VTE. However, ongoing studies comparing DOACs with low-molecular-weight heparin will provide additional information.

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