HealthDay News – New recommendations have been developed for antithrombotic therapy for venous thromboembolism (VTE). The Antithrombotic Therapy for VTE Disease: CHEST Guideline was published online January 7 in CHEST.

Clive Kearon, MD, PhD, from McMaster University in Hamilton, Canada, and colleagues updated recommendations for 12 topics and addressed 3 new topics related to antithrombotic therapy for VTE disease.

The guideline authors recommended dabigatran, rivaroxaban, apixaban, or edoxaban over vitamin K antagonist (VKA) therapy, and VKA therapy over low molecular weight heparin (LMWH) as long-term anticoagulant therapy for VTE and no cancer. LMWH was suggested over VKA, dabigatran, rivaroxaban, apixaban, or edoxaban for VTE and cancer. Recommendations for who should stop anticoagulation at 3 months or receive extended therapy have not changed. The authors recommended against an inferior vena cava filter for VTE treated with anticoagulants. They also recommended not using compression stockings to routinely prevent post-thrombotic syndrome for deep vein thrombosis (DVT). Clinical surveillance was recommended over anticoagulation with a low risk of recurrent VTE, and anticoagulation over surveillance with a high risk, for patients with subsegmental pulmonary embolism and no proximal DVT.


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“The guideline presents stronger recommendations and weaker suggestions for treatment based on the best available evidence, and identifies gaps in our knowledge and areas for future research,” Dr Kearon said in a news release from the American College of Chest Physicians.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline. Chest. 2016. doi:10.1016/j.chest.2015.11.026.