Welcome to the thirteenth monthly email of PERTinent Updates featuring a select group of articles for your review. We aim to inform and update our members with the most recent major developments in the fields of PERT/VTE so that we in the PERT Consortium can continue to be at the leading edge of improving care for this vulnerable and overlooked group of patients.

This month’s “From Our Own” section features articles by Victor Tapson in The European Respiratory Journal; Thomas Todoran, Jay Giri, Geoffrey Barnes, Rachel Rosovsky, Michael Jaff, Kenneth Rosenfield and Christopher Kabrhel in The Journal of Thrombosis and Thrombolysis; David Dudzinski, Oren Friedman, Akhilesh Sista and James Horowitz in The Journal of Multidisciplinary Healthcare; and Parth Rali in The American Journal of Respiratory and Critical Care Medicine.

Apixaban for the prevention of venous thromboembolism in high-risk ambulatory cancer patients receiving chemotherapy: Rational and design of the AVERT trial, is featured in “Upcoming Trials”.

Highlights from the trial Include:

• Thromboprophylaxis decreases the risk of VTE in cancer patients receiving chemotherapy.
• Apixaban may be a safe and effective option for thromboprophylaxis in these patients.
• AVERT will randomize cancer patients at high risk for VTE to apixaban vs. placebo.

Also, under “FDA Approvals“, is information on the recently approved ANDEXXA. ANDEXXA, coagulation factor Xa (recombinant), inactivated-zhzo is a recombinant modified human Factor Xa (FXa) protein indicated for patients treated with rivaroxaban and apixaban, when reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding.

Please send us information here regarding your recently published manuscript in any field related to VTE/PE/PERT and we will include it in the next edition of PERTinent Updates. This is a way for the Consortium to follow the work of individual members while also celebrating the larger impact we are having on this field.

Best,
Your colleagues on the Education Committee

Risk Stratification

Impact of syncope and pre-syncope on short-term mortality in patients with acute pulmonary embolism.
Roncon L, Zuin M, Casazza F, Becattini C, Bilato C, Zonzin P. Eur J Intern Med. 2018 Apr 11. pii: S0953-6205(18)30141-9. [Epub ahead of print] PMID: 29655808

Treatment

Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D).
Young AM, Marshall A, Thirlwall J, Chapman O, Lokare A, Hill C, Hale D, Dunn JA, Lyman GH, Hutchinson C, MacCallum P, Kakkar A, Hobbs FDR, Petrou S, Dale J, Poole CJ, Maraveyas A, Levine M. J Clin Oncol. 2018 May 10:JCO2018788034. [Epub ahead of print] PMID: 29746227

Early Versus Delayed Use of Ultrasound-Assisted Catheter-Directed Thrombolysis in Patients With Acute Submassive Pulmonary Embolism.
Edla S, Rosman H, Neupane S, Boshara A, Szpunar S, Daher E, Rodriguez D, LaLonde T, Yamasaki H, Mehta RH, Attallah A. J Invasive Cardiol. 2018 May;30(5):157-162. PMID: 29715164

Upcoming Trials

Apixaban for the prevention of venous thromboembolism in high-risk ambulatory cancer patients receiving chemotherapy: Rational and design of the AVERT trial.
Kimpton M, Wells PS, Carrier M. Thromb Res. 2018 Apr;164 Suppl 1:S124-S129. PMID: 2970347

FDA Approvals

Adnexxa (Adnaxanet) for reversal of Factor Xa inhibitors
— press release, FDA listing

From Our Own…

Management Appropriateness and Outcomes of Patients with Acute Pulmonary Embolism.
Jimenez D, Bikdeli B, Barrios D, Morillo R, Nieto R, Guerassimova I, Muriel A, Jara-Palomares L, Moores L, Tapson V, Yusen RD, Monreal M; RIETE investigators. Eur Respir J. 2018 May 3. pii: 1800445. [Epub ahead of print] PMID: 29724918

Treatment of submassive and massive pulmonary embolism: a clinical practice survey from the second annual meeting of the Pulmonary Embolism Response Team Consortium.
Todoran TM, Giri J, Barnes GD, Rosovsky RP, Chang Y, Jaff MR, Rosenfield K, Kabrhel C; PERT Consortium. J Thromb Thrombolysis. 2018 Apr 17. [Epub ahead of print] PMID: 29667126

Multidisciplinary approach to the management of pulmonary embolism patients: the pulmonary embolism response team (PERT).
Root CW, Dudzinski DM, Zakhary B, Friedman OA, Sista AK, Horowitz JM. J Multidiscip Healthc. 2018 Apr 5;11:187-195. eCollection 2018. Review. PMID: 29670358 [PubMed]

Submassive Pulmonary Embolism.
Rali PM, Criner GJ. Am J Respir Crit Care Med. 2018 Apr 19. [Epub ahead of print] PMID: 29672125