Studies presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition compare new and standard-of-care treatments for blood clots and further illuminate clot risks in vulnerable populations, such as cancer patients.
Although significant advances have been made in the treatment and prevention of blood clots through new and improved therapies for clotting disorders, challenges remain in balancing the benefits and risks of these therapies. Specifically, while these treatments can reduce patients’ risk of suffering potentially life-threatening clotting that can lead to heart attack, stroke, or pulmonary embolism, they can also lead to severe treatment-related bleeding. Blood clots also present a particular challenge for certain at-risk populations, specifically patients with cancer. One study presented will unveil the first real-world safety data for a new class of oral anticoagulants that had mainly been previously evaluated in clinical trials. Two additional studies will explore the burden of blood clots for patients with cancer, including validating previous guidelines and proposing new preventive measures for minimizing clot risk. Another study will describe a targeted, experimental compound that appears to reduce clot risk without increasing bleeding, a critical marker of safety for anticoagulant therapy.
“The scientific community is on a continual path of progress to introduce safe and effective therapies that can both treat and prevent blood clots,” said Mary Cushman, MD, moderator of the press conference and Professor of Medicine at the University of Vermont in Burlington. “Studies presented evaluating new and standard treatments and determining optimal treatment strategies for cancer patients with blood clots represent advancement in the field.”
Novel Anticoagulants Shown to be Safe, Effective Outside Clinical Trial Setting
Bleeding in Patients with Atrial Fibrillation Treated with Non Vitamin K Antagonist Oral Anticoagulants: A Population-Based Study 
For many years, the majority of patients with the heart rhythm disorder atrial fibrillation have taken warfarin, a type of drug known as a vitamin K antagonist (VKA), to reduce their risk of stroke and other complications. While effective, warfarin is a challenging treatment as patients must undergo regular monitoring to assess bleeding risk and there is no recommended standardized dose. Recently, three novel, non-VKA oral anticoagulants (NOACs) – dabigatran, apixaban, and rivaroxaban – have received approval from the U.S. Food and Drug Administration as VKA alternatives that may provide greater ease of use. While Phase III clinical trials have demonstrated that NOACs are at least as effective and as safe as warfarin, their associated bleeding risks outside of a controlled clinical trial setting have remained unclear.