Treatment and Secondary Prevention of Cancer-Associated Thrombosis. Supplement to Module 6. Overview. Introduction UFH as initial treatment for VTE LMWH as initial treatment for VTE Fondaparinux as initial treatment for VTE Transition to long-term therapy with vitamin K antagonists
Supplement to Module 6
Initial Phase Thrombosis
≥5 d treatment with SC LMWH, IV UFH, monitored SC UFH, fixed-dose SC UFH, or SC fondaparinux1
Discontinue when INR >2.0 for 24 h
Initiation of VKA together with LMWH, UFH, or fondaparinux on first treatment day
Necessary for patients at continuous risk for recurrence
Duration of treatment is dependent on underlying disease and risk factors
Appropriate treatment can reduce the risk of recurrence to approximately 5% at 3 months2Two Phases of VTE Treatment
1. Kearon C et al. Chest. 2008;133:454S-545S.
2. Prandoni P et al. Vasc Med. 1998;3:57-60.
Brandjes DP et al. N Engl J Med. 1992;327:1485-1489.
Hirsh J et al. Chest. 1998;114:489S-510S.
Lee AYY. In: Khorana AA, Francis CW, eds: Cancer-associated thrombosis: New findings in translational science, prevention, and treatment. Informa Healthcare USA. 2008.
Büller HR et al. Ann Intern Med. 2004;140:867-873.
Schulman S et al. N Engl J Med. 1995;332:1661-1665.
1. Lee AY et al. N Engl J Med. 2003;349:146-153.
2. Prandoni P et al. Blood. 2002;100:3484-3488.
Meyer G et al. Arch Intern Med. 2002;162:1729-1735.
Lee AY et al. N Engl J Med. 2003;349:146-153.