New oral anticoagulants in the treatment of venous thromboembolism: Critical analysis of clinical trials

The standard treatment of venous thromboembolism has been the use of parenteral unfractionated or low molecular weight heparin, followed by oral vitamin K antagonists. New oral anticoagulants that selectively inhibit coagulation proteins such as thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban, edoxaban) have shown to be effective alternative treatments in venous thromboembolism patients in clinical trials, without requiring routine parenteral anticoagulation. However, these studies have a number of limitations relating to the patient enrollment and study design. All these factors will need to be considered when deciding which of the new oral anticoagulants to use in individual patients. (C) 2014 SEACV. Published by Elsevier Espana, S.L.U. All rights reserved.