Direct oral anticoagulants versus aspirin for venous thromboembolism prophylaxis after orthopedic surgery

Cost-Effectiveness of Venous Thromboembolism Prophylaxis During Neoadjuvant Chemotherapy for Ovarian Cancer

“…Recent studies have compared the efficacy and safety of DOACs with low-dose aspirin in other clinical settings. Anderson et al 40 and Yang et al 41 compared the rate of VTE with aspirin versus DOACs after orthopedic surgery, with no difference in clinical outcomes; these studies are not entirely applicable as they both excluded patients with active malignancy and addressed only postoperative prophylaxis. Aspirin is currently recommended for low-risk patients with multiple myeloma on immunomodulatory imide drug–based regimens.…”

“…Recent studies have revealed daily low-dose aspirin to be as effective as DOACs for VTE prophylaxis following orthopedic surgery. 40,41 We hypothesized that aspirin may constitute an alternative and potentially cost-effective VTE prophylaxis strategy in patients with neoadjuvant-treated ovarian cancer and performed an exploratory analysis to test this. For this analysis, we made the conservative assumption that although low-dose aspirin might be less effective at preventing VTE than DOACs, the rate of clinically significant bleeding events could still be similar to or greater than that of DOACs.…”

“…For this analysis, we made the conservative assumption that although low-dose aspirin might be less effective at preventing VTE than DOACs, the rate of clinically significant bleeding events could still be similar to or greater than that of DOACs. 40,41 We assigned low-dose aspirin a VTE rate of 10.2% (applying a conservative HR 5 0.75 to the baseline VTE rate of 13.6%), a major bleeding rate of 2.6%, and a clinically relevant nonmajor bleeding rate of 4.6% (equal to rates of adverse effects in DOAC group).…”