CO26 | Direct oral anticoagulants for the treatment of venous thromboembolism in patients with cancer: a FADOI survey among Campanian Internal Medicine wards
E. Marrone1, C. Arturo2, F. Cannavacciuolo3, D. D’Ambrosio4, F. Gallucci1, M. Amitrano3, C. Di Gennaro2, P. Morella1, A. Maffettone5 | 1UOC Medicina 3, AORN A Cardarelli, Napoli, 2UOC Medicina Generale, PO A. Rizzoli, Ischia (NA), 3UOC Medicina Interna, AO Moscati, Avellino, 4UOC Medicina Generale, PO Aversa (CE), 5UOC Medicina ad indirizzo cardiovascolare e dismetabolico AORN dei Colli, Ospedale Monaldi, Italy
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Premises and Purpose of the study: Venous thromboembolism (VTE) is an important cause of morbidity and mortality among patients with cancer. According to recent guidelines its initial treatment may involve low-molecular-weight heparin (LMWH) or a direct oral anticoagulant (DOAC), as well as for long-term anticoagulation. Therefore, we conducted this Survey aimed at knowing aspects of the treatment of VTE in patients with cancer in the Campania Region.
Materials and Methods: In December 2023, a questionnaire (Q) with 14 questions relating to the treatment of VTE in patients (pts) with cancer was sent to FADOI members in Campania. 55 pratictioners from 40 Internal Medicine Wards of Campania.
Results: The percentage of pts with cancer admitted in Internal Medicine ward presenting VTE: <25% (69%), 25-50%(31%). All pts with cancer and VTE begin anticoagulant treatment during hospidalitation. Its initial treatment is based on LMWH: all pts (29%), a small part 9%, most (62%), while on DOAC: all pts (11%), none (1.8%), a small part (52.7%), most 34.5%. Comorbidities in the 70% of the cases influence the choice of treatment. Mortality of this pts: <20% (42%), 20-40%(22%),41-60%(4%), unknown (32%). In the discharge letter of pts with cancer and VTE, LMWH are prescribed: <25% (45.5%), 25-50% (31%), 51-75% (9%), >75% (14.5%), while DOAC: <25% (11%), 25-50% (31%), 51-75% (16%), 75% (42%).
Conclusions: In Internal Medicine Wards of Campania LMWH is preferred over DOAC in initial treatment of VTE in pts with cancer, while for long-term anticoagulation DOAC is preferred over LMWH.
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