In the absence of direct comparisons between NOACs, and no convincing indirect evidence that one NOAC is superior to another, we do not have a preference for one NOAC over another NOAC. Factors that may in uence which anticoagulant is chosen for initial and long-term treatment of VTE are summarized in Table 6. This decision is also expected to be sensitive to patient preferences. *3. In patients with DVT of the leg or PE and cancer ( cancer-associated thrombosis ), as long-term ( rst 3 months) anticoagulant therapy, we suggest LMWH over VKA therapy (Grade 2B), dabigatran (Grade or edoxaban (Grade 2C). Remarks: Initial parenteral anticoagulation is given before dabigatran and edoxaban, is not given before rivaroxaban and apixaban, and is overlapped with VKA therapy. See text for factors that in uence choice of therapy. Choice of anticoagulant for extended therapy (after 3 months and no scheduled stop date) When AT9 was written, other than a comparison of low- and standard-intensity anticoagulant therapy,46 there were no comparisons of different types of extended therapy. Since AT9, dabigatran has been compared with VKA therapy for extended treatment of VTE and found to be similarly effective but associated with less bleeding Extended treatment with markedly reduces recurrent VTE without being associated with much bleeding (Tables 8-10, e-Tables 10-12).49,50 These studies provide moderate quality evidence that dabigatran is as effective and as safe as VKA for extended treatment of VTE (Table 7, e-Table 9) and provide moderate quality evidence that each of the NOACs are effective at preventing recurrent VTE without being associated with a high risk of bleeding (Tables 8-10, e-Tables 10-12). In AT9, we suggested that if a decision was made to use extended treatment of VTE, the same anticoagulant should be used as was used for the initial treatment period. 