Author Affiliations: Pharmacy Service (Dr DeCarolis) and Hematology/Oncology Section (Dr Johnson), Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.
We thank Dr Miyares for comments and interest in our article.1 On the basis of the CLOT (Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer) trial,2 they question whether patients with active cancer should be maintained on low-molecular weight heparin therapy and not transitioned to warfarin therapy. We appreciate calling attention to the potential influence of active malignancy on our results. Treatment of patients with active malignancy had no effect on our results because none of them had major bleeding or recurrent thromboembolism.
DeCarolis DD, Johnson GJ. Additional Considerations to Precede Selection of Enoxaparin Therapy—Reply. JAMA Intern Med. 2013;173(11):1036-1037. doi:10.1001/jamainternmed.2013.1050