New SSC Guidance Released by JTH on the Categorization of Patients with Provoked or Unprovoked VTE
Tuesday, July 19, 2016
Posted by: Luke Blount
The Journal of Thrombosis and Haemostasis (JTH) has accepted the following article on guidance from the Scientific and Standardization Committee (SSC) of the ISTH:
Categorization of patients as having provoked or unprovoked venous thromboembolism
Whether an episode of venous thromboembolism (VTE) was unprovoked or provoked by an environmental (or acquired) risk factor and, if it was provoked, whether the provoking factor was transient or persistent, has important prognostic and treatment implications. If thrombosis was provoked by a major transient risk factor, such as recent surgery, there is a very low risk of recurrence after stopping therapy. At the other extreme, if thrombosis was provoked by a persistent and progressive risk factor, such as metastatic cancer, there is a high risk of recurrence after stopping therapy. Patients with neither an important transient nor persistent provoking risk factor for thrombosis, who are often referred to as having ‘unprovoked’ VTE, have an intermediate risk of recurrence after stopping therapy.
Because of the implications for risk of recurrence and how long patients should be treated, it is often important to be able to categorize episodes of VTE as being provoked or unprovoked. This SSC statement discusses issues that are relevant to this categorization and proposes criteria that can be used in clinical practice and for clinical research to categorize episodes of VTE as provoked by a transient risk factor, provoked by a persistent risk factor or unprovoked. Our goal is to standardize what is meant by these terms, identify the strengths and limitations of this terminology, and improve the consistency with which patients are categorized into one of these three groups. Greater consistency in the use of this categorization is expected to benefit clinical practice and investigation. Read more.