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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB0965 - Delphi Survey of Canadian Physicians to Determine Optimal Anticoagulant Treatment Approaches for Patients with Cancer and Splanchnic Venous Thrombosis

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Presenting Author(s)

    • AZ

      Amin Zahrai, BSc

      Researcher
      Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
      Ottawa, Ontario, Canada

      • Co-Author(s)

    • AD

      Aurélien Delluc

      Professor, MD, PhD
      Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
      Ottawa, Ontario, Canada

    • Marc Carrier, MD

      MD, MSc
      Ottawa Hospital Research Institute, Ottawa, ON, Canada
      Ottawa, Ontario, Canada

    Background: Cancer and myeloproliferative neoplasm (MPN) are both associated with greater risk of venous thromboembolism (VTE), including splanchnic vein thromboses (SVT). Anticoagulation is often recommended to manage SVTs. Anticoagulation is associated with lower risk of recurrent VTE but higher risk of clinically-relevant bleeding patients with cancer and SVTs. For patients with MPN and SVTs, anticoagulation is associated with lower risks of both recurrent VTE and bleeding.

    Aims: To do a survey of Canadian practice on management of patients with cancer/MPN and SVTs

    Methods: A 15-question online survey was developed on LimeSurvey and distributed to members of the Canadian Venous Thromboembolism Research Network (CanVECTOR), Thrombosis Canada, and Canadian Hematology Society. Responses were collected over 2 months and tallied to assess for consensus through coefficients of variances less than 0.30.

    Results: 25/45 (55.6%) have practiced for more than 10 years. 40/45 (88.9%) were hematologists and. 31/45 (68.9%) were involved in research activities. 44/44 (100%) and 40/45 (88.9%) reported that the risk of recurrent VTE and bleeding are well-controlled, respectively, with either LMWH or DOACs in patients with cancer and SVT. 35/44 (79.5%) felt that randomized trials comparing DOACs to. LMWHs is feasible. Only 25/45 (55.5%) were comfortable with a placebo-controlled trial in this population and 18/25 (72%) reported that an absolute risk reduction of 5% in recurrent VTE would be the minimal clinically significance difference. Responses were heterogenous for MPN patients. Half of respondents said that a 1% increase in risk of bleeding with DOACs, compared to warfarin, would be acceptable in this patient population.

    Conclusion(s): Canadian physicians seem to agree on most approaches when managing patients with cancer/MPN and SVT. Our Delphi survey emphasize the need for randomized controlled trials between anticoagulants for these populations.