Clinical controversies in the treatment of cancer-associated venous thromboembolism

Nachar, Victoria R; Schepers, Allison J

doi:10.1177/1078155220984371

Cited by 2 publications

(1 citation statement)

References 86 publications

(111 reference statements)

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“…Yet, uncertainties remain regarding their treatment beyond the initial 6 month treatment period [ 71 ]. The guidelines opt for the continued an anticoagulant treatment, but the recommendations are only sparsely supported by randomized evidence, and they are generally without reference to dosage or specific decision tools to aid these challenging decisions [ 61 , 72 ].…”

Section: Recommendations For Specific Populationsmentioning

confidence: 99%

Long-Term Management of Pulmonary Embolism: A Review of Consequences, Treatment, and Rehabilitation

Højen

Nielsen

Overvad

et al. 2022

JCM

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The concept of pulmonary embolism is evolving. Recent and emerging evidence on the treatment of specific patient populations, its secondary prevention, long-term complications, and the unmet need for rehabilitation has the potential to change clinical practice for the benefit of the patients. This review discusses the recent evidence from clinical trials, observational studies, and guidelines focusing on anticoagulation treatment, rehabilitation, emotional stress, quality of life, and the associated outcomes for patients with pulmonary embolism. Guidelines suggest that the type and duration of treatment with anticoagulation should be based on prevalent risk factors. Recent studies demonstrate that an anticoagulant treatment that is longer than two years may be effective and safe for some patients. The evidence for extended treatment in cancer patients is limited. Careful consideration is particularly necessary for pulmonary embolisms in pregnancy, cancer, and at the end of life. The rehabilitation and prevention of unnecessary deconditioning, emotional distress, and a reduced quality of life is an important, but currently they are unmet priorities for many patients with a pulmonary embolism. Future research could demonstrate optimal anticoagulant therapy durations, follow-ups, and rehabilitation, and effective patient-centered decision making at the end of life. A patient preferences and shared decision making should be incorporated in their routine care when weighing the benefits and risks with primary treatment and secondary prevention.

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Section: Recommendations For Specific Populationsmentioning

confidence: 99%