title: Venous Thromboembolism in Cancer: An Update of Treatment and Prevention in the Era of Newer Anticoagulants.
abstract: Cancer patients are at major risk of developing venous thromboembolism (VTE), resulting in increased morbidity and economic burden. While a number of theories try to explain its pathophysiology, its risk stratification can be broadly done in cancer-related, treatment-related, and patient-related factors. Studies report the prophylactic use of thrombolytic agents to be safe and effective in decreasing VTE-related mortality/morbidity especially in postoperative cancer patients. Recent data also suggest the prophylactic use of low molecular weight Heparins (LMWHs) and Warfarin to be effective in reducing VTEs related to long-term central venous catheter use. In a double-blind, multicenter trial, a new ultra-LMWH Semuloparin has shown to be efficacious in preventing chemotherapy-associated VTE's along with other drugs, such as Certoparin and Nadoparin. LMWHs are reported to be very useful in preventing recurrent VTEs in advanced cancers and should be preferred over full dose Warfarin. However, their long-term safety beyond 6 months has not been established yet. Furthermore, this paper discusses the safety and efficacy of different drugs used in the treatment and prevention of recurrent VTEs, including Bemiparin, Semuloparin, oral direct thrombin inhibitors, parenteral and direct oral factor Xa inhibitors.
authors: Department of Internal Medicine, Division of Cardiovascular Epidemiology and Cardiology, Wake Forest University , Winston Salem, NC , USA.
authors: Waqas
authors: W
authors: Qureshi
authors: Department of Internal Medicine, University of Maryland , Baltimore, MD , USA.
authors: Zeeshan
authors: Z
authors: Ali
authors: Allama Iqbal Medical College , Lahore , Pakistan.
authors: Waseem
authors: W
authors: Amjad
authors: Department of Internal Medicine, Henry Ford Hospital, Wayne State University , Detroit, MI , USA.
authors: Zaid
authors: Z
authors: Alirhayim
authors: Rawalpindi Medical College , Rawalpindi , Pakistan.
authors: Hina
authors: H
authors: Farooq
authors: Khyber Medical College , Peshawar , Pakistan.
authors: Shayan
authors: S
authors: Qadir
authors: Department of Internal Medicine, Division of Nephrology and Hypertension, Wake Forest University , Winston Salem, NC , USA.
authors: Fatima
authors: F
authors: Khalid
authors: King Abdulaziz Medical Center , Riyadh , Saudi Arabia.
authors: Mouaz H
authors: MH
authors: Al-Mallah
keywords: apixaban; low molecular weight heparin; newer oral anticoagulants; risk stratification; rivaroxaban; thromboprophylaxis; venous thromboembolism