Stephan Moll, MD writes… An information article on various aspects of thrombophilia, written for patients and family members, was published today – available here - as a Vascular Disease Patient Information Page in the journal Vascular Medicine. It addresses (a) in which patient with venous thromboembolism to consider thrombophilia testing, (b) what tests might be appropriate to do, (c) how the test results might influence length of anticoagulation therapy (d), what contraceptives are safe to use in women with a history of DVT or PE or thrombophilia, and (e) in which family members to consider thrombophilia testing. This article can be used as an education handout for patients in clinic or the hospital who have DVT, PE, venous thrombosis in unusual locations, or an established thrombophilia.
Last updated: April 1st, 2015
Stephan Moll, MD writes... The annual American Society of Hematology (ASH) meeting took place in Dec 2014 in San Francisco. A summary of the clinically relevant thrombosis and anticoagulation presentation and abstracts is presented here (Top 10 ASH Highlights).
Disclosure: I have been a consultant to Portola, Daiichi, Janssen, and Boehringer-Ingelheim.
Last updated: Jan 27th, 2015
Stephan Moll, MD writes…. Today (Jan 8th, 2015) the FDA approved yet another new oral anticoagulant, Savaysa (edoxaban), for the treatment of DVT and PE, as well as for atrial fibrillation. The FDA press release is here (link). Savaysa is the 4th of the NOACS now approved for VTE treatment. This table summarizes the differences, advantages and disadvantages comparing the 4 drugs. The detailed drug package insert with dosing information is here (link). Read the rest of this entry »
Stephan Moll, MD writes (Dec 17, 2014)… The American Society of Hematology (ASH) published last week as part of its Choosing Wisely® campaign two things that physicians dealing with DVT, PE and anticoagulants should avoid [ref 1]. Read the rest of this entry »
Stephan Moll, MD writes (on Dec 8th, 2014)… A publication this week in the New England Journal of Medicine reports on an investigational drug that protects patients from VTE without increasing the risk of bleeding [reference below]. Too good to be true? Possibly, but may be not. Additional studies will have to tell. Read the rest of this entry »
Stephan Moll, MD writes (on 12/5/2014)… Venous thromboembolism (VTE) prophylaxis in hospitalized patients is important; it is also mandated by the Joint Commission [ref]. We have developed at the University of North Carolina (UNC) a guidance document (link here; UNC VTE prophylaxis guidance document) as a resource for our health care professionals to assist in making evidence-based decisions on which patients to give what type of VTE prophylaxis.
Recommendations provided in this document are a reflection of current guidelines, clinical evidence, and UNC institutional initiatives, but are not intended to replace clinical judgment or patient evaluation. Readers are welcome to use this document for their institution or practice – using it as is or modifying it.
Joint Commission VTE measures (link here)
Last updated: Dec 5th, 2014
Stephan Moll, MD writes (on Nov 7th, 2014)… A N Engl J Med publication this week [ref 1] reports on a new reversal agent (PER977 = Aripazine = ciraparantag) that may be effective against a number of different new oral anticoagulants. Read the rest of this entry »
Stephan Moll, MD writes… Is there a dose change or limitation for the use of Xarelto® (rivaroxaban) in very obese or underweight patients? Read the rest of this entry »
Stephan Moll, MD writes… Aspirin is beneficial in preventing recurrent venous thromboembolism (VTE) in patients who have had a previous episode of unprovoked VTE and who have been treated with anticoagulant therapy, a publication in the journal Circulation re-confirms this week: Aspirin reduces the risk of recurrent VTE by more than a third without significantly increasing the risk of bleeding [ref 1]. This publication does not report results of a new study, but is rather a further analysis of the previously published WARFASA and ASPIRE aspirin trials [ref 2,3]. Read the rest of this entry »
Stephan Moll, MD writes… Apixaban (Eliquis®) was approved by the FDA this week (Aug 21, 2014) for the treatment of DVT and PE. The approval covers (a) acute DVT/PE management and (b) prevention of recurrent DVT/PE. Read the rest of this entry »