VTE PROPHYLAXIS NOW RECOMMENDED FOR CANCER PATIENTS
The National Comprehensive CancerNetwork (NCCN) recently issued guidelinesrecommending inpatient prophylacticanticoagulation therapy withunfractionated heparin, low-molecularweightheparin (LMWH), or fondaparinux.The guidelines do not address outpatientprophylaxis, but they suggestimmediate and long-term treatmentonce an episode of venous thromboembolism(VTE) occurs. The NCCN recommends3 to 6 months of treatment fordeep vein thrombosis, 6 to 12 months oftreatment for pulmonary embolism, andindefinite treatment for patients withactive cancer or persistent risk factors.
The NCCN recommends the use ofLMWH or warfarin for long-term treatmentand secondary prevention. Preliminarydata suggest an improved survivalbenefit using LMWH, however. Thenew guidelines may be accessed atwww.nccn.org/professionals/physician_gls/sPDF/vte.pdf.
Dr. Garrett is a clinical pharmacistpractitioner at Cornerstone Health Carein High Point, NC.