TY - JOUR
T1 - American society of hematology 2020 guidelines for management of venous thromboembolism
T2 - Treatment of deep vein thrombosis and pulmonary embolism
AU - Ortel, Thomas L.
AU - Neumann, Ignacio
AU - Ageno, Walter
AU - Beyth, Rebecca
AU - Clark, Nathan P.
AU - Cuker, Adam
AU - Hutten, Barbara A.
AU - Jaff, Michael R.
AU - Manja, Veena
AU - Schulman, Sam
AU - Thurston, Caitlin
AU - Vedantham, Suresh
AU - Verhamme, Peter
AU - Witt, Daniel M.
AU - Florez, Ivan D.
AU - Izcovich, Ariel
AU - Nieuwlaat, Robby
AU - Ross, Stephanie
AU - Schünemann, Holger J.
AU - Wiercioch, Wojtek
AU - Zhang, Yuan
AU - Zhang, Yuqing
N1 - Funding Information:
The work of this panel was coordinated with 9 other guideline panels (addressing other aspects of VTE) by ASH and the McMaster GRADE Centre (funded by ASH under a paid agreement). Project oversight was provided initially by a coordination panel, which reported to the ASH Committee on Quality, and then by the coordination panel chair (A.C.) and vice chair (H.J.S.). ASH vetted and appointed individuals to the guideline panel. The McMaster GRADE Centre vetted and retained researchers to conduct systematic reviews of evidence and to coordinate the guideline-development process. The membership of the panel and the GRADE Centre team is described in Supplement 1.
PY - 2020/10/13
Y1 - 2020/10/13
N2 - Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), occurs in;1 to 2 individuals per 1000 each year, corresponding to;300 000 to 600 000 events in the United States annually. Objective: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support patients, clinicians, and others in decisions about treatment of VTE. Methods: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and adult patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 28 recommendations for the initial management of VTE, primary treatment, secondary prevention, and treatment of recurrent VTE events. Conclusions: Strong recommendations include the use of thrombolytic therapy for patients with PE and hemodynamic compromise, use of an international normalized ratio (INR) range of 2.0 to 3.0 over a lower INR range for patients with VTE who use a vitamin K antagonist (VKA) for secondary prevention, and use of indefinite anticoagulation for patients with recurrent unprovoked VTE. Conditional recommendations include the preference for home treatment over hospital-based treatment for uncomplicated DVT and PE at low risk for complications and a preference for direct oral anticoagulants over VKA for primary treatment of VTE.
AB - Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), occurs in;1 to 2 individuals per 1000 each year, corresponding to;300 000 to 600 000 events in the United States annually. Objective: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support patients, clinicians, and others in decisions about treatment of VTE. Methods: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and adult patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 28 recommendations for the initial management of VTE, primary treatment, secondary prevention, and treatment of recurrent VTE events. Conclusions: Strong recommendations include the use of thrombolytic therapy for patients with PE and hemodynamic compromise, use of an international normalized ratio (INR) range of 2.0 to 3.0 over a lower INR range for patients with VTE who use a vitamin K antagonist (VKA) for secondary prevention, and use of indefinite anticoagulation for patients with recurrent unprovoked VTE. Conditional recommendations include the preference for home treatment over hospital-based treatment for uncomplicated DVT and PE at low risk for complications and a preference for direct oral anticoagulants over VKA for primary treatment of VTE.
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U2 - 10.1182/bloodadvances.2020001830
DO - 10.1182/bloodadvances.2020001830
M3 - Review article
C2 - 33007077
AN - SCOPUS:85092394396
VL - 4
SP - 4693
EP - 4738
JO - Blood advances
JF - Blood advances
SN - 2473-9529
IS - 19
ER -