Living FRIendly Summaries of the Body of Evidence using Epistemonikos (FRISBEE)
Medwave 2021;21(04):e8178 doi: 10.5867/medwave.2021.04.8178

Direct acting oral anticoagulants versus low molecular weight heparin for primary thromboprophylaxis in cancer patients

Natalia Méndez, Constanza Norambuena, Symón Silva, Valentín López

Abstract

Introduction
Low molecular weight heparin is currently the standard therapy for the primary prevention of thromboembolic disease in cancer patients. The use of direct-acting anticoagulants could be an alternative, but its efficacy and safety profile in these types of patients remains unclear.

Methods
We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from identified reviews, analyzed data from primary studies, performed a meta-analysis, and prepared a summary table of results using the GRADE method.

Results and conclusions
We identified four systematic reviews that together included two primary studies, of which both correspond to trials. We conclude that the use of direct-acting oral anticoagulants probably increases the outcome of major bleeding and likely slightly increases the risk of thromboembolic disease. No studies were found that evaluated the outcome of quality of life or mortality.


 

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