How do you approach DOAC dose reduction for secondary prophylaxis of VTE in cancer-associated thrombosis?

Data from the API-CAT trial (Mahé et al., PMID 40162636) show that de-escalation of apixaban after 6 months was non-inferior compared to the standard dose with respect to recurrent VTE. Although there was no difference in major bleeding, the lower dose of apixaban was superior from the clinically re...

Yes, typically. There are situations where I tend to keep patients on the full dose, assuming they’re tolerating it well, like significant overweight (>120 kg) or coexisting high-risk comorbidities (e.g., prothrombin 20210 in addition to active malignancy).