Direct oral anticoagulants versus low-molecular-weight heparin for prevention of recurrent VTE in cancer patients

In patients with cancer who have venous thromboembolism (VTE) events, long-term anticoagulation with low-molecular-weight heparin (LMWH) is recommended to prevent recurrent VTE. However, LMWH requires subcutaneous administration, which can be burdensome. The multicenter randomized CANVAS trial compared direct oral anticoagulants (DOACs) versus LMWH in patients with cancer and a new VTE. The recurrent VTE rate at 6 months was 6.1% with DOAC versus 8.8% with LMWH. Severe adverse events occurred in 33.8% of the patients in the DOAC group and 35.1% of the patients in the LMWH group. The authors conclude that these findings support use of a DOAC to prevent recurrent VTE in patients with cancer (visual abstract).