There is an increasing trend towards using DOACs in this clinical context based on recent clinical trials. For example, it was shown that edoxaban (a DOAC used in Europe) may be as effective as low-molecular-weight heparin (LMWH) in reducing venous thromboembolism (VTE) recurrence/bleeding. The latest guidelines from ACCP and NCCN (see below) recommend administering oral factor Xa inhibitor (apixaban, edoxaban, or rivaroxaban) rather than LMWH during initiation and treatment phase of deep vein thrombosis (DVT). Because edoxaban and rivaroxaban reported to be associated with higher risk of gastrointestinal major bleeding compared to LMWH in patients with luminal gastrointestinal malignancy, apixaban or LWMH may be preferred in these patients. Learn more here.