How do you treat a patient with warfarin failure, with therapeutic INR 2-3 at the time of DVT, and no underlying malignancy or hypercoagulable state?

Is lifelong LMWH the anticoagulant of choice? Would DOACs be an option?

Answer from: Medical Oncologist at Community Practice

I would give DOACs a shot in this case. The INR of 2-3 at the time of DVT "Diagnosis" might have been <2 at the time of DVT "development/occurrence" depending on how frequently the INR had been checked. I would, of course, maximize risk factors control as well.

Answer from: at Academic Institution

Let INR drop to 1.5 and then start heparin.

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Medical Oncologist at Eglin AFB Hosp
Are you using heparin as a bridge to DOAC with the...

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How do you treat a patient with warfarin failure, with therapeutic INR 2-3 at the time of DVT, and no underlying malignancy or hypercoagulable state?

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