Purpose:
Abiraterone has been proven to be an effective agent used in the management of metastatic castration-resistant prostate cancer, significantly improving overall and progression free survival. Due to the pharmacodynamic and pharmacokinetic properties of abiraterone, concurrent use with anticoagulation may pose a challenge for clinicians. Thrombosis within the cancer setting continues to increase patient mortality therefore appropriate anticoagulation management through the use of a management algorithm, can reduce adverse events and increase quality of life.

Methods:
A review of the literature was preformed to identify relevant randomized controlled trials, meta-analyses and retrospective studies. Major society guidelines were reviewed to further aid in developing the anticoagulation protocol for nonvalvular atrial fibrillation and venous thromboembolism within this patient population. In appraising the literature, a clinical framework was designed to aid clinicians in the management of those patients receiving abiraterone concurrently with an anticoagulant.

Results: 
In this review, we describe the potential interactions between abiraterone and various anticoagulants, and provide management strategies based on the most recent literature for atrial fibrillation, venous thromboembolism and mechanical heart valves. 

Conclusion:
Abiraterone therapy has become a mainstay of the management of advanced prostate cancer, and is often used over prolonged years. In this review we have summarized a framework of how to use abiraterone in men with prostate cancer on anticoagulants. Evidence available to date suggests that patients with an indication for anticoagulation such as atrial fibrillation, VTE and mechanical heart-valves can be treated safely with abiraterone in the appropriate setting, with appropriate monitoring.

MANAGEMENT OF ANTICOAGULATION IN PATIENTS WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER RECEIVING ABIRATERONE + PREDNISONE