Blood Transfusion - 2 2015 (April - June)

The treatment of venous thromboembolism with novel oral anticoagulants: warnings and limitations
 
Authors:  Paolo Prandoni
Pages:  178-80
To cite this article:  Blood Transfus 2015; 13: 178-80
Doi:  10.2450/2015.0002-15
Published online: 

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The availability of antithrombotic compounds that can be administered orally at fixed doses, without the need for laboratory controls because of their predictable pharmacokinetics and pharmacodynamics, and have a lower potential for drug and food interactions has opened new horizons for the treatment of patients with venous thromboembolic disorders1. Such antithrombotic compounds include drugs that inhibit factor Xa (rivaroxaban, apixaban and edoxaban) and drugs that inhibit thrombin (dabigatran etexilate). Indeed, with the advent of the direct, novel oral anticoagulants (NOA) it has become realistic to dissociate the antithrombotic effect from the haemorrhagic potential to a much greater extent than is possible with the older anticoagulants2,3. Furthermore, the demonstration that a few compounds can treat patients with venous thromboembolism (VTE) effectively and safely from the beginning, without the need for initial parenteral administration of either heparins or fondaparinux, is expected to streamline the management of venous thromboembolic disorders on an outpatient basis4. Finally, the favourable results of studies addressing long-term treatment with NOA are likely to influence decisions about the optimal duration of anticoagulation in patients with unprovoked VTE5. [...]
  
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