The Clot Thickens: Analyzing the Incidence of Direct Oral Anticoagulant Failure in Patients with Prostate Cancer on Concomitant Androgen Receptor Antagonist Therapy
Recommended Citation
Katchi R, Kalem N, Jarjis J, Koloian N, Yankulina O. The Clot Thickens: Analyzing the Incidence of Direct Oral Anticoagulant Failure in Patients with Prostate Cancer on Concomitant Androgen Receptor Antagonist Therapy. Am J Health Syst Pharm 2026; 83:S803.
Document Type
Conference Proceeding
Publication Date
3-6-2026
Publication Title
Am J Health Syst Pharm
Keywords
Pharmacology & Pharmacy
Abstract
Purpose: A common first-line therapy for prostate cancer treatment is an androgen receptor antagonist (ARA). Many patients with prostate cancer are on concomitant therapy with direct oral anticoagulants (DOACs) and ARAs. Studies have shown significant pharmacokinetic interactions between DOACs and ARAs, decreasing the effectiveness of DOACs, which can lead to a higher risk of thromboembolic events. This study aims to assess the incidence of thromboembolic events in patients on concurrent DOAC and ARA therapies. Methods: This is an IRB-approved, retrospective case series conducted at Henry Ford Health Cancer Institute. Eligible patients include adults (≥18 years) with prostate cancer who received a second generation ARA prescribed by a Henry Ford oncologist between January 1, 2023, and June 30, 2025, and who were on a concurrent DOAC. Exclusion criteria include the use of anticoagulation other than DOACs within seven days of DOAC initiation, body mass index < 18.5 or ≥40 kg/m2, and body weight < 40 or >120 kg. Thromboembolic events will be defined as new diagnoses of deep vein thrombosis, pulmonary embolism, ischemic stroke, myocardial infarction, or other arterial thrombosis confirmed by diagnostic imaging and/or physician documentation. Extracted variables will include demographics, comorbidities, prostate cancer stage and treatments, DOAC indication and regimen, and ARA treatment details (agent, dose, frequency, duration, discontinuation). Descriptive statistics will summarize patient characteristics and outcomes, reported as frequencies, proportions, and medians with interquartile ranges. Secondary analyses will explore thromboembolic incidence across prostate cancer stages. We anticipate enrolling approximately100 eligible patients during the study timeframe.
Volume
83
First Page
S803
