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What do systematic reviews say?

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Evidence found and GRADE certainty

50 questions · 51 findings · 17 reviews · Headline outcomes only

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No studies found 5 · 9.8%GRADE not reported 3 · 5.9%Very low 10 · 19.6%Low 13 · 25.5%Moderate 11 · 21.6%High 9 · 17.6%

Anticoagulant vs placebo or no intervention

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people with distal DVT

Anticoagulant leads to higher clinically relevant non‐major bleeding ( compared with no intervention or placebo (high certainty).

1 finding from 1 review

Direct oral anticoagulant (DOAC) prophylaxis vs no prophylaxis

Major bleeding · ambulatory people with cancer without venous thromboembolism receiving systemic therapy

Direct oral anticoagulant (DOAC) prophylaxis showed no clear difference in major bleeding compared with no prophylaxis (moderate certainty).

1 finding from 1 review

Direct oral anticoagulant secondary prophylaxis vs vitamin K antagonist secondary prophylaxis

Major bleeding · patients with active cancer with venous thromboembolism

Direct oral anticoagulant secondary prophylaxis showed no clear difference in major bleeding compared with vitamin K antagonist secondary prophylaxis (low certainty).

1 finding from 1 review

Direct oral anticoagulant secondary prophylaxis vs Low molecular weight heparin secondary prophylaxis

Major bleeding · patients with cancer with venous thromboembolism

Direct oral anticoagulant secondary prophylaxis showed no clear difference in major bleeding compared with low molecular weight heparin secondary prophylaxis (low certainty).

1 finding from 1 review

Direct oral anticoagulant secondary prophylaxis vs Low molecular weight heparin secondary prophylaxis

Major GI bleeding · patients with cancer with venous thromboembolism

Direct oral anticoagulant secondary prophylaxis showed no clear difference in major GI bleeding compared with low molecular weight heparin secondary prophylaxis (low certainty).

1 finding from 1 review

Anticoagulants (chosen at investigators' discretion) vs placebo

Major bleeding · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

Anticoagulants (chosen at investigators' discretion) showed no clear difference in bleeding ‐ major Treatment duration 28 ‐ 42 days compared with placebo (low certainty).

1 finding from 1 review

Direct oral anticoagulant secondary prophylaxis vs Low molecular weight heparin secondary prophylaxis

Major non‐GI bleeding · patients with cancer with venous thromboembolism

It is very uncertain whether direct oral anticoagulant secondary prophylaxis changes major non‐GI bleeding compared with low molecular weight heparin secondary prophylaxis (very low certainty).

1 finding from 1 review

Anticoagulants (chosen at investigators' discretion) vs placebo

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

The review found no eligible studies for this question.

1 finding from 1 review

Direct oral anticoagulant secondary prophylaxis vs Low molecular weight heparin secondary prophylaxis

Major upper GI bleeding · patients with cancer with venous thromboembolism

It is very uncertain whether direct oral anticoagulant secondary prophylaxis changes major upper GI bleeding compared with low molecular weight heparin secondary prophylaxis (very low certainty).

1 finding from 1 review

Direct oral anticoagulant secondary prophylaxis vs Low molecular weight heparin secondary prophylaxis

Major lower GI bleeding · patients with cancer with venous thromboembolism

It is very uncertain whether direct oral anticoagulant secondary prophylaxis changes major lower GI bleeding compared with low molecular weight heparin secondary prophylaxis (very low certainty).

1 finding from 1 review

Factor Xa inhibitors vs Anticoagulants

Major bleeding · Anticoagulants in ACS

Factor Xa inhibitors showed no clear difference in major bleeding at 30 days compared with anticoagulants (high certainty).

2 findings from 1 review