The New Oral Anticoagulants In Clinical Practice.
W. Gonsalves, R. Pruthi, M. Patnaik
Published 2013 · Medicine
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Vitamin K antagonists were the only class of oral anticoagulants available to clinicians for decades. However, with the US Food and Drug Administration approval of new oral anticoagulants, such as dabigatran, rivaroxaban, and apixaban, clinicians now have a broader choice. Given the recent approval and availability of these medications, several questions arise while deciding which of them would be best suited for a particular patient. This article provides a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of these drugs, their pharmacokinetic and pharmacodynamic properties, and a practical approach to their clinical use. For this review, we conducted searches of PubMed and MEDLINE for articles published between January 1, 2000, and January 30, 2013, using the following search terms: oral anticoagulants, dabigatran, apixaban, rivaroxaban, novel anticoagulants, bleeding complications, management of bleeding complications, pharmacodynamics, and pharmacokinetics. Studies published in English were selected for inclusion in this review, as were additional articles identified from bibliographies.
This paper references
Apixaban versus enoxaparin for thromboprophylaxis after hip replacement.
M. Lassen (2010)
Thrombolysis treatment for acute ischaemic stroke in a patient on treatment with dabigatran.
M. C. Matute (2011)
Oral rivaroxaban for symptomatic venous thromboembolism.
R. Bauersachs (2010)
Frequency of adverse events in patients with poor anticoagulation: a meta-analysis
Natalie Oake (2007)
Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors
S. Kaatz (2012)
Removal of dabigatran by hemodialysis.
Don N. Chang (2013)
Using the HEMOCLOT direct thrombin inhibitor assay to determine plasma concentrations of dabigatran
J. Stangier (2012)
Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial
A. K. Kakkar (2008)
Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty.
B. Eriksson (2008)
Update on Antithrombotic Therapy: New Anticoagulants
J. Eikelboom (2010)
Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial
B. Eriksson (2007)
Oral rivaroxaban for the treatment of symptomatic pulmonary embolism.
H. Büller (2012)
HIT: treatment easier, prevention harder.
T. Warkentin (2012)
New Oral Anticoagulants: Comparative Pharmacology with Vitamin K Antagonists
F. Scaglione (2013)
Reviewing the reality: why we need to change
P. Lin (2005)
Oral dabigatran versus enoxaparin for thromboprophylaxis after primary total hip arthroplasty (RE-NOVATE II*). A randomised, double-blind, non-inferiority trial.
B. Eriksson (2011)
Apixaban in patients with atrial fibrillation.
S. Connolly (2011)
Clinical laboratory measurement of direct factor Xa inhibitors: anti-Xa assay is preferable to prothrombin time assay.
Y. C. Barrett (2010)
Apixaban for extended treatment of venous thromboembolism.
G. Agnelli (2013)
Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator in a Stroke Patient Treated with Dabigatran
A. De Smedt (2010)
Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial
A. Turpie (2009)
The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects.
J. Stangier (2007)
Interference of the new oral anticoagulant dabigatran with frequently used coagulation tests
W. Halbmayer (2012)
Management consensus guidance for the use of rivaroxaban--an oral, direct factor Xa inhibitor.
A. Turpie (2012)
Apixaban versus warfarin in patients with atrial fibrillation.
C. Granger (2011)
Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial
L. Wallentin (2010)
Dabigatran Versus Warfarin in Patients With Atrial Fibrillation: An Analysis of Patients Undergoing Cardioversion
Rangadham Nagarakanti (2011)
Dabigatran versus warfarin in patients with atrial fibrillation.
S. Connolly (2009)
Dabigatran etexilate for stroke prevention in patients with atrial fibrillation: resolving uncertainties in routine practice.
M. Huisman (2012)
Evaluation of the antifactor XA chromogenic assay for measuring rivaroxaban plasma concentrations using calibrators and controls
M. M. Samama (2012)
Reversal of Rivaroxaban and Dabigatran by Prothrombin Complex Concentrate: A Randomized, Placebo-Controlled, Crossover Study in Healthy Subjects
E. Eerenberg (2011)
Evaluation of the anti-factor Xa chromogenic assay for the measurement of rivaroxaban plasma concentrations using calibrators and controls.
M. Samama (2012)
Coagulation assays and anticoagulant monitoring
Dorothy M A Funk (2012)
2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the Europe
V. Fuster (2011)
Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty.
M. Lassen (2008)
Decrease in the oral bioavailability of dabigatran etexilate after co-medication with rifampicin.
S. Haertter (2012)
Oral thrombin inhibitor dabigatran etexilate vs North American enoxaparin regimen for prevention of venous thromboembolism after knee arthroplasty surgery.
Jeffrey S. Ginsberg (2009)
Pharmacodynamic and pharmacokinetic basics of rivaroxaban
R. Kreutz (2012)
New oral anticoagulants: which one should my patient use?
J. I. Weitz (2012)
Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
C. Kearon (2012)
Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment.
K. Fox (2011)
Effects of the oral, direct factor Xa inhibitor rivaroxaban on commonly used coagulation assays
A. Hillarp (2011)
Safety of prothrombin complex concentrates for rapid anticoagulation reversal of vitamin K antagonists. A meta-analysis.
F. Dentali (2011)
Apixaban or enoxaparin for thromboprophylaxis after knee replacement.
M. Lassen (2009)
Myocardial Ischemic Events in Patients with Atrial Fibrillation Treated with Dabigatran or Warfarin in the RE-LY Trial
S. Hohnloser (2012)
Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE‐MODEL randomized trial
B. Eriksson (2007)
Population pharmacokinetic analysis of the oral thrombin inhibitor dabigatran etexilate in patients with non‐valvular atrial fibrillation from the RE‐LY trial
K-H Liesenfeld (2011)
How I treat with anticoagulants in 2012: new and old anticoagulants, and when and how to switch.
S. Schulman (2012)
Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.
M. Patel (2011)
Myocardial Ischemic Events in Patients With Atrial Fibrillation Treated With Dabigatran or Warfarin in the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) Trial
S. Hohnloser (2012)
Rivaroxaban and false positive lupus anticoagulant testing.
E. Merriman (2011)
Adsorption of Dabigatran Etexilate in Water or Dabigatran in Pooled Human Plasma by Activated Charcoal in Vitro.
J. Ryn (2009)
Dabigatran and postmarketing reports of bleeding.
M. R. Southworth (2013)
Dabigatran association with higher risk of acute coronary events: meta-analysis of noninferiority randomized controlled trials.
K. Uchino (2012)
Effects of the oral, direct thrombin inhibitor dabigatran on five common coagulation assays.
T. Lindahl (2011)
Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial
M. Lassen (2010)
Dabigatran etexilate--a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity.
J. van Ryn (2010)
Heparin-induced thrombocytopenia: in vitro studies on the interaction of dabigatran, rivaroxaban, and low-sulfated heparin, with platelet factor 4 and anti-PF4/heparin antibodies.
K. Krauel (2012)
This paper is referenced by
Endothermal heat-induced thrombosis (EHIT): reports on two case treated with rivaroxaban and literature review Trombose induzida pelo calor endovenoso: relato de dois casos tratados com rivaroxabana e revisão da literatura
Walter Luiz Aldá Júnior (2016)
Novel oral anticoagulants: what dermatologists need to know.
Molly Plovanich (2015)
In reply-dabigatran for heparin-induced thrombocytopenia.
Wilson I Gonsalves (2013)
Therapy with activated prothrombin complex concentrate is effective in reducing dabigatran-associated blood loss in a porcine polytrauma model.
Markus Honickel (2016)
Update on Medication Use in Older Adults
Kimberly Keefer (2016)
Investigation into Patients treated in an Oral and Maxillofacial Unit between 2012 and 2014 , who were taking the Novel Anticoagulants
Nazia Din (2019)
Manejo perioperatorio de los anticoagulantes orales directos en cirugía urgente y sangrado. Monitorización y tratamiento hemostático
F. Hidalgo (2015)
Prise en charge par les services d’urgences des accidents hémorragiques graves chez les patients traités par les nouveaux anticoagulants oraux (NACOs)
A. Momo-Boma (2014)
Non-vitamin K antagonist oral anticoagulants and heart failure.
Richard Isnard (2016)
Dose requirements for idarucizumab reversal of dabigatran in a lethal porcine trauma model with continuous bleeding.
Markus Honickel (2017)
Small molecule inhibitors in the treatment of cerebral ischemia
J. Flores (2014)
Direct Oral Anticoagulants
Erin Robinson (2015)
Quick Response Tracheotomy
Graeme Browne (2016)
Quality Control Approach to Anticoagulants and Transfusion.
Erin L Mckean (2016)
Non-Vitamin K Oral Anticoagulants (NOACs) and Their Reversal
Sujan T Reddy (2017)
Risk of Gastrointestinal Bleeding in Patients Taking Non–Vitamin K Antagonist Oral Anticoagulants: A Systematic Review and Meta‐analysis
Corey S. Miller (2017)
Monitoring of warfarin therapy: Preliminary results from a longitudinal pilot study
T. Lomonaco (2018)
Replacement of the L-iduronic acid unit of the anticoagulant pentasaccharide idraparinux by a 6-deoxy-L-talopyranose – Synthesis and conformational analysis
Fruzsina Demeter (2018)
Quantitation of the Oral Anticoagulants Dabigatran, Rivaroxaban, Apixaban, and Warfarin in Plasma Using Ultra-Performance Liquid Chromatography with Tandem Mass Spectrometry (UPLC-MS/MS).
Jaime H. Noguez (2016)
Lessons from the trials Hokusai-VTE : Edoxaban for the treatment of venous thromboembolism
K. Said (2014)
How to apply knowledge that we have: Rivaroxaban effective protection and therapy
Željko Delić (2015)
Novel Oral Anticoagulants in Atrial Fibrillation: Update on Apixaban
Kenechukwu Mezue (2017)
Aminocaproic Acid and Tranexamic Acid Fail to Reverse Dabigatran-Induced Coagulopathy
M. Levine (2016)
Factors influencing the recruitment of lactating women in a clinical trial involving direct oral anticoagulants: a qualitative study
Yating Zhao (2018)
Viral receptors for flaviviruses: Not only gatekeepers
L. G. Oliveira (2019)
Risk of Thromboembolic Events in Patients with Non-Valvular Atrial Fibrillation After Dabigatran or Rivaroxaban Discontinuation – Data from the Ljubljana Registry
N. Vene (2016)
Nanoparticle systems that exploit host biology for diagnosis and treatment of disease
K. Lin (2014)
What The Vascular Specialist Need To Know About The Newer Oral Anticoagulants, Their Pitfalls And How To Use Them
D. Poldermans (2013)
Direct-Acting Oral Anticoagulants: Practical Considerations for Emergency Medicine Physicians
W. Peacock (2016)
The use of oral anticoagulants for the treatment of venous thromboembolic events in an ED.
Charles V. Pollack (2014)
Advances in oral anticoagulation therapy - What's in the pipeline?
P S S Rao (2017)
UvA-DARE ( Digital Academic Repository ) Factor XI as target for antithrombotic therapy
Boross (2014)See more