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The next few pages focus on the diagnosis, treatment and long-term care of patients with venous thromboembolism (VTE), including the importance of long-term anticoagulation for those at risk of recurrent events.
VTE is a significant burden
Each year in the UK, up to 1 in every 1,000 people are affected by VTE, comprising deep vein thrombosis (DVT), which affects approximately two thirds of patients with VTE, and pulmonary embolism (PE) with or without DVT, which affects the remaining third.1,2 The major risk associated with untreated DVTs is that about 50% of patients with untreated proximal DVT will develop a symptomatic PE within 3 months,3 with the fatality rate of those suffering a serious PE being around 1 in 10.1
Around 30% of people who have had a VTE develop further problems, such as VTE recurrence or death, within 10 years – even with treatment.1,4 A significant proportion of patients suffer from lifelong morbidity following an initial VTE;4 around 20–50% develop post-thrombotic syndrome after an initial DVT2 and a minority of patients develop chronic thromboembolic pulmonary hypertension (CTEPH) after a PE.4
Many of those affected by VTE already have risk factors such as recent major surgery or a serious illness.1 Continuing anticoagulation treatment after 3 months is less beneficial for people who have had a provoked VTE if the provoking factor is no longer present, because of the lower rate of VTE recurrence compared with unprovoked VTE.5
However, for most people who had an unprovoked VTE and low bleeding risk, it is considered likely that the benefits of continuing anticoagulation treatment after 3 months outweigh the risks. The benefits and risks of continuing treatment long-term need to be carefully balanced and discussed with the patient.5
Adverse events should be reported. Reporting forms and information can be found via United Kingdom – The yellow card scheme at www.mhra.gov.uk/yellowcard, or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Bristol-Myers Squibb via email@example.com or 0800 731 1736 (United Kingdom).
CTEPH=Chronic Thromboembolic Pulmonary HypertensionDVT=Deep Vein ThrombosisMHRA=Medicines and Healthcare products and Regulatory AgencyPE=Pulmonary EmbolismVTE=Venous Thromboembolism
Thrombosis UK. Venous Thrombosis Leaflet.
Cushman M. Semin Hematol. 2007; 44: 62–69.
Kearon C. Circulation; 2003; 107(23 Suppl 1): I22-30.
Winter MP et al. J Thromb Haemost; 2017; 15: 1531–1540.
NICE. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing [NG158]. 26 March 2020.
Job code: 432-GB-2100108
Date of preparation: September 2021
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