{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T06:00:57Z","timestamp":1672898457731},"reference-count":40,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The major practical advantage of the direct oral anticoagulants (DOACs), comprising the thrombin inhibitor dabigatran and the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban, over vitamin K antagonists is their fixed dosing without the need for laboratory monitoring. With the recent, rapid introduction of the DOACs for the treatment of acute venous thromboembolism (VTE), clinicians are now faced with various questions regarding the efficacy and safety of these compounds overall and in specific high-risk populations. The collective evidence from 6 large clinical trials involving 27,000 patients has demonstrated that DOACs are as effective as vitamin K antagonists (VKA) in preventing recurrent VTE while being associated with a significantly lower risk of major bleeding. These findings are consistent in subgroups of patients with pulmonary embolism, the elderly, and those patients with a high body weight or moderate renal insufficiency, making these agents suitable for a broad spectrum of patients with VTE. DOACs are also an attractive treatment option in patients with VTE and concomitant cancer, thrombotic antiphospholipid syndrome, or heparin-induced thrombocytopenia, but the currently available clinical data is insufficient to make evidence-based recommendations on the use of DOACs in these settings. Several studies evaluating the efficacy and safety of DOACs in these high-risk populations are underway.<\/jats:p>","DOI":"10.1182\/asheducation-2015.1.125","type":"journal-article","created":{"date-parts":[[2016,9,15]],"date-time":"2016-09-15T15:23:25Z","timestamp":1473953005000},"page":"125-131","update-policy":"http:\/\/dx.doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":9,"title":["Using direct oral anticoagulants (DOACs) in cancer and other high-risk populations"],"prefix":"10.1182","volume":"2015","author":[{"given":"Nick","family":"van Es","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry R.","family":"B\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"234","reference":[{"issue":"6396","key":"2019111704055066800_B1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0140-6736(46)91429-8","article-title":"Thrombosis; early diagnosis and abortive treatment with heparin","volume":"1","author":"Bauer","year":"1946","journal-title":"Lancet"},{"issue":"7138","key":"2019111704055066800_B2","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/S0140-6736(60)92299-6","article-title":"Anticoagulant drugs in the treatment of pulmonary embolism: a controlled trial","volume":"1","author":"Barritt","year":"1960","journal-title":"Lancet"},{"issue":"2","key":"2019111704055066800_B3","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/00000658-193808000-00002","article-title":"The use of heparin in thrombosis","volume":"108","author":"Murray","year":"1938","journal-title":"Ann Surg"},{"issue":"7","key":"2019111704055066800_B4","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1161\/CIRCULATIONAHA.113.004450","article-title":"Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis","volume":"129","author":"Schulman","year":"2014","journal-title":"Circulation"},{"issue":"24","key":"2019111704055066800_B5","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1056\/NEJMoa0906598","article-title":"Dabigatran versus warfarin in the treatment of acute venous thromboembolism","volume":"361","author":"Schulman","year":"2009","journal-title":"N Engl J Med"},{"issue":"9","key":"2019111704055066800_B6","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa1302507","article-title":"Oral apixaban for the treatment of acute venous thromboembolism","volume":"369","author":"Agnelli","year":"2013","journal-title":"N Engl J Med"},{"issue":"15","key":"2019111704055066800_B7","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1056\/NEJMoa1306638","article-title":"Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism","volume":"369","author":"B\u00fcller","year":"2013","journal-title":"N Engl J Med"},{"issue":"14","key":"2019111704055066800_B8","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1056\/NEJMoa1113572","article-title":"Oral rivaroxaban for the treatment of symptomatic pulmonary embolism","volume":"366","author":"B\u00fcller","year":"2012","journal-title":"N Engl J Med"},{"issue":"26","key":"2019111704055066800_B9","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1056\/NEJMoa1007903","article-title":"Oral rivaroxaban for symptomatic venous thromboembolism","volume":"363","author":"Bauersachs","year":"2010","journal-title":"N Engl J Med"},{"issue":"4","key":"2019111704055066800_B10","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2005.01204.x","article-title":"Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients","volume":"3","author":"Schulman","year":"2005","journal-title":"J Thromb Haemost"},{"issue":"12","key":"2019111704055066800_B11","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1182\/blood-2014-04-571232","article-title":"Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials","volume":"124","author":"Van Es","year":"2014","journal-title":"Blood"},{"issue":"1","key":"2019111704055066800_B12","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1053\/j.gastro.2013.02.041","article-title":"New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis","volume":"145","author":"Holster","year":"2013","journal-title":"Gastroenterology"},{"issue":"apr24 2","key":"2019111704055066800_B13","doi-asserted-by":"crossref","first-page":"h1857","DOI":"10.1136\/bmj.h1857","article-title":"Comparative risk of gastrointestinal bleeding with dabigatran, rivaroxaban, and warfarin: population based cohort study","volume":"350","author":"Abraham","year":"2015","journal-title":"BMJ"},{"issue":"10","key":"2019111704055066800_B14","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1182\/blood-2013-04-460121","article-title":"Epidemiology of cancer-associated venous thrombosis","volume":"122","author":"Timp","year":"2013","journal-title":"Blood"},{"key":"2019111704055066800_B15","doi-asserted-by":"crossref","first-page":"e419S","DOI":"10.1378\/chest.11-2301","article-title":"Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Kearon","year":"2012","journal-title":"Chest"},{"issue":"17","key":"2019111704055066800_B16","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1200\/JCO.2013.49.1118","article-title":"Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update","volume":"31","author":"Lyman","year":"2013","journal-title":"J Clin Oncol"},{"issue":"2","key":"2019111704055066800_B17","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1056\/NEJMoa025313","article-title":"Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer","volume":"349","author":"Lee","year":"2003","journal-title":"N Engl J Med"},{"key":"2019111704055066800_B18","doi-asserted-by":"crossref","article-title":"A randomized trial of long-term tinzaparin, a low molecular weight heparin (LMWH), versus warfarin for treatment of acute venous thromboembolism (VTE) in cancer patients: the CATCH study","author":"Lee","DOI":"10.1182\/blood.V124.21.LBA-2.LBA-2"},{"key":"2019111704055066800_B19","first-page":"1","article-title":"Treatment with dabigatran or warfarin in patients with venous thromboembolism and cancer","volume":"113","author":"Schulman","year":"2015","journal-title":"Thromb Haemost"},{"key":"2019111704055066800_B20","doi-asserted-by":"crossref","article-title":"Edoxaban for long-term treatment of venous thromboembolism in cancer patients","author":"Raskob","DOI":"10.1182\/blood.V122.21.211.211"},{"issue":"5","key":"2019111704055066800_B21","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1182\/blood-2013-04-496257","article-title":"Antiphospholipid antibodies and the risk of recurrence after a first episode of venous thromboembolism: a systematic review","volume":"122","author":"Garcia","year":"2013","journal-title":"Blood"},{"issue":"2","key":"2019111704055066800_B22","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/j.1538-7836.2009.03674.x","article-title":"Clinical course of high-risk patients diagnosed with antiphospholipid syndrome","volume":"8","author":"Pengo","year":"2010","journal-title":"J Thromb Haemost"},{"key":"2019111704055066800_B23","doi-asserted-by":"crossref","first-page":"e152S","DOI":"10.1378\/chest.11-2295","article-title":"Evidence-based management of anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Holbrook","year":"2012","journal-title":"Chest"},{"issue":"6","key":"2019111704055066800_B24","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.autrev.2014.01.053","article-title":"14th International Congress on antiphospholipid antibodies task force report on antiphospholipid syndrome treatment trends","volume":"13","author":"Erkan","year":"2014","journal-title":"Autoimmun Rev"},{"key":"2019111704055066800_B25","first-page":"1","article-title":"Safety and efficacy of oral direct inhibitors of thrombin and factor Xa in antiphospholipid syndrome","author":"Noel","year":"2015","journal-title":"Autoimmun Rev"},{"key":"2019111704055066800_B26","first-page":"1","article-title":"The use of rivaroxaban in patients with antiphospholipid syndrome: a series of 12 cases","author":"Son","year":"2015","journal-title":"Thromb Res"},{"issue":"5","key":"2019111704055066800_B27","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1160\/th14-03-0272","article-title":"Failure of dabigatran and rivaroxaban to prevent thromboembolism in antiphospholipid syndrome: a case series of three patients","volume":"112","author":"Schaefer","year":"2014","journal-title":"Thromb Haemost"},{"issue":"10","key":"2019111704055066800_B28","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/ajh.23797","article-title":"New oral anticoagulants may not be effective to prevent venous thromboembolism in patients with antiphospholipid syndrome","volume":"89","author":"Win","year":"2014","journal-title":"Am J Hematol"},{"issue":"10","key":"2019111704055066800_B29","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1177\/0961203315581207","article-title":"Rivaroxaban in antiphospholipid syndrome (RAPS) protocol: a prospective, randomized controlled phase II\/III clinical trial of rivaroxaban versus warfarin in patients with thrombotic antiphospholipid syndrome, with or without SLE","volume":"24","author":"Cohen","year":"2015","journal-title":"Lupus"},{"issue":"3","key":"2019111704055066800_B30","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1056\/NEJMcp1411910","article-title":"Clinical practice: heparin-induced thrombocytopenia","volume":"373","author":"Greinacher","year":"2015","journal-title":"N Engl J Med"},{"issue":"8","key":"2019111704055066800_B31","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1056\/NEJMct1206642","article-title":"Nonheparin anticoagulants for heparin-induced thrombocytopenia","volume":"368","author":"Kelton","year":"2013","journal-title":"N Engl J Med"},{"issue":"1","key":"2019111704055066800_B32","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/j.1365-2141.2008.07300.x","article-title":"Rivaroxaban-an oral, direct Factor Xa inhibitor-has potential for the management of patients with heparin-induced thrombocytopenia","volume":"143","author":"Walenga","year":"2008","journal-title":"Br J Haematol"},{"issue":"5","key":"2019111704055066800_B33","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1182\/blood-2011-05-353391","article-title":"Heparin-induced thrombocytopenia: in vitro studies on the interaction of dabigatran, rivaroxaban, and low-sulfated heparin, with platelet factor 4 and anti-PF4\/heparin antibodies","volume":"119","author":"Krauel","year":"2012","journal-title":"Blood"},{"key":"2019111704055066800_B34","first-page":"935","article-title":"Apixaban as an alternate anticoagulant for the management of patients with heparin-induced thrombocytopenia","volume":"11","author":"Walenga","year":"2013","journal-title":"J Thromb Haemost"},{"key":"2019111704055066800_B35","first-page":"1","article-title":"Design of the rivaroxaban for heparin-induced thrombocytopenia study","author":"Linkins","year":"2014","journal-title":"J Thromb Thrombolysis"},{"issue":"20","key":"2019111704055066800_B36","doi-asserted-by":"crossref","first-page":"4160","DOI":"10.1182\/blood-2012-07-443051","article-title":"Predictive value of the 4Ts scoring system for heparin-induced thrombocytopenia: a systematic review and meta-analysis","volume":"120","author":"Cuker","year":"2012","journal-title":"Blood"},{"issue":"1","key":"2019111704055066800_B37","first-page":"112","article-title":"Dabigatran, a direct thrombin inhibitor, can be a life-saving treatment in heparininduced thrombocytopenia","volume":"9","author":"Mirdamadi","year":"2013","journal-title":"ARYA Atheroscler"},{"issue":"2","key":"2019111704055066800_B38","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/MBC.0000000000000205","article-title":"Rivaroxaban for arterial thrombosis related to heparin-induced thrombocytopenia","volume":"26","author":"Hantson","year":"2015","journal-title":"Blood Coagul Fibrinolysis"},{"key":"2019111704055066800_B39","first-page":"68","article-title":"Rivaroxaban in the Treatment of Heparin-Induced Thrombocytopenia","author":"Sartori","year":"2015","journal-title":"J Thromb Thrombolysis"},{"issue":"1","key":"2019111704055066800_B40","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.thromres.2014.06.005","article-title":"First experiences with the use of rivaroxaban in the treatment of heparin-induced thrombocytopenia","volume":"135","author":"Ng","year":"2015","journal-title":"Thromb Res"}],"container-title":["Hematology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ashpublications.org\/hematology\/article-pdf\/2015\/1\/125\/1250374\/bep00115000125.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/ashpublications.org\/hematology\/article-pdf\/2015\/1\/125\/1250374\/bep00115000125.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,17]],"date-time":"2019-11-17T09:06:13Z","timestamp":1573981573000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/hematology\/article\/2015\/1\/125\/20678\/Using-direct-oral-anticoagulants-DOACs-in-cancer"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,5]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,12,5]]}},"URL":"https:\/\/doi.org\/10.1182\/asheducation-2015.1.125","relation":{},"ISSN":["1520-4391","1520-4383"],"issn-type":[{"value":"1520-4391","type":"print"},{"value":"1520-4383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,5]]}}}