Poster No. 139 Direct Oral Anticoagulant Use in the Treatment of Venous Thromboembolism Associated with Cancer

Abstract

Abstract Venous thromboembolism (VTE) is a common cause of death and complications in patients with cancer. Choosing an anticoagulant is challenging because these patients are at high risk of recurrent VTE and bleeding. Major guidelines recommended the use of low-molecular-weight heparin (LMWH), but recent studies recommend consideration of direct anticoagulants (DOACs) in selected patients. However, their clinical use is limited by the increased risk of bleeding and interaction with other drugs. Retrospective study, including patients followed since 2015 in VTE consultation, with cancer-associated VTE. Patients with an ECOG Performance Status Scale of 4 and with contraindications for anticoagulation were excluded. We reported the incidence of recurrent VTE and haemorrhage within the first year after anticoagulation. In this study, we compared the efficacy and safety of the use of DOACs versus LMWH in patients with cancer-associated VTE. 91 patients were included, 55% male, median age of 70 years and most frequent ECOG Performance Status Scale of 0 (44%). 65% of the patients were treated with DOACs. The most common cancers included: colorectal (26%), genitourinary (25%), haematological (10%) and upper gastrointestinal (9%). Were reported 6 recurrent VTE events (4 pulmonary embolisms, 2 deep vein thrombosis) and 6 minor bleeding events, without any major or fatal event. The occurrence of recurrent thromboembolic events or bleeding was not significantly different between patients treated with LMWH or DOACs. In this real-world observational study, we confirm the efficacy and safety of the use of DOACs in the treatment of VTE associated with cancer in selected patients.