New oral anticoagulants for the treatment of venous thromboembolism

被引:16
作者
Agnelli, Giancarlo [1 ]
Becattini, Cecilia [1 ]
Franco, Laura [1 ]
机构
[1] Univ Perugia, I-06100 Perugia, Italy
关键词
venous thromboembolism; oral anticoagulants; dabigatran; rivaroxaban; apixaban; edoxaban; venous thrombosis; pulmonary embolism; DEEP-VEIN THROMBOSIS; XA INHIBITOR RIVAROXABAN; PULMONARY-EMBOLISM; INITIAL TREATMENT; THERAPY; WARFARIN; RECURRENCE; DABIGATRAN; FONDAPARINUX; APIXABAN;
D O I
10.1016/j.beha.2013.07.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
New oral anticoagulants, acting either as direct factor-Xa or thrombin inhibitors, have been evaluated for the acute and long-term treatment of venous thromboembolism (VTE). Dabigatran and rivaroxaban are as effective as conventional therapy (heparin/vitamin K antagonists) without safety concerns. Rivaroxaban allows a single-drug regimen even in patients with pulmonary embolism, while dabigatran requires 5-7 days of initial heparin treatment. The results of clinical trials with apixaban and edoxaban will become available in the coming months. Rivaroxaban, apixaban and dabigatran are more effective than placebo for the extended treatment of VTE. Apixaban is effective in both therapeutic and prophylactic doses. Considering both efficacy and bleeding complications, all these agents have a favorable net clinical benefit. Dabigatran is as effective and safe as warfarin for the extended treatment of VTE. It is conceivable that the new oral anticoagulants will become the standard therapy for VTE in the next years. (C) 2013 Elsevier Ltd. All rights reserved.
引用
收藏
页码:151 / 161
页数:11
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