The American Society of Hematology (ASH) has issued a new guideline for the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE). The 2020 guideline, created by a multidisciplinary global panel, provides 28 recommendations for the initial management of venous thrombosis as well as primary treatment, secondary prevention, and treatment of recurrent thrombotic events. The panel issued strong recommendations for the use of thrombolytic therapy in patients with a PE resulting in hemodynamic compromise, use of an international normalized ratio (INR) goal of 2.0–3.0 in patients with a history of venous thromboembolism (VTE) who are treated with a vitamin K antagonist for secondary prevention, and use of anticoagulation for an indefinite period in patients with recurrent unprovoked VTE. Conditional recommendations include a preference for home treatment for uncomplicated DVT and PE in patients at low risk of complications and a preference for direct-acting oral anticoagulants over vitamin K antagonists for primary treatment of VTE.

Two ACCP members, Nathan P. Clark, Pharm.D., FCCP, BCPS, and Daniel M. Witt, Pharm.D., FCCP, BCPS, served on the ASH guideline panel. Clark is a clinical assistant professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and clinical pharmacy supervisor for the Clinical Pharmacy Anticoagulation and Anemia Service at Kaiser Permanente, Colorado. Witt is professor and chair of the Department of Pharmacotherapy and assistant dean of clinical affairs at the University of Utah College of Pharmacy. Clark and Witt have made significant contributions to the body of knowledge regarding anticoagulation. Clark is also a member of the board of directors of the Anticoagulation Forum, and Witt served as a panel member for the 2012 CHEST consensus guidelines for antithrombotic therapy. ACCP appreciates their work in developing this new ASH guideline and their dedication to optimizing treatment and improving outcomes for patients requiring anticoagulation.