American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy
Witt DM, Nieuwlaat R, Clark N, Ansell J, Holbrook A, Skov J, Shehab N, Mock J, Myers T, Dentali F, Crowther M, Agarwal A, Bhatt M, Khatib R, Riva JJ, Zhang Y and Guyatt G
Blood Advances 27 November 2018 – volume 2, number 22
ABSTRACT:
Some practical issues represent a challenge in the optimization of anticoagulants usage to cure venous thromboembolism (VTE). The American Society of Hematology (ASH) has issued these evidence-based guidelines to provide a guide for patients, clinicians and other health care professionals on how to use anticoagulants to manage VTE. In these guidelines, it is assumed that the decision of using anticoagulant has already been established.
The chosen panel has established 25 recommendations and 2 good practice statements for optimal management of patients treated with anticoagulants.
Strong recommendations are in favor of patient self-management of international normalized ratio (INR) with home point-of-care INR monitoring for vitamin K antagonist therapy and against using periprocedural low-molecular-weight heparin (LMWH) bridging therapy. Conditional recommendations refer to basing treatment dosing of LMWH on patient body weight, not using anti–factor Xa monitoring to guide LMWH dosing, using specialized anticoagulation management services, and restart anticoagulation after episodes of life-threatening bleeding.