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Novel Oral Anticoagulants and Atrial Fibrillation: Efficacy and Safety Considerations
Author(s) -
Apostolakis Stavros
Publication year - 2013
Publication title -
drug development research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.582
H-Index - 60
eISSN - 1098-2299
pISSN - 0272-4391
DOI - 10.1002/ddr.21108
Subject(s) - apixaban , dabigatran , medicine , rivaroxaban , atrial fibrillation , warfarin , dosing , contraindication , discovery and development of direct thrombin inhibitors , edoxaban , intensive care medicine , antithrombotic , stroke (engine) , direct thrombin inhibitor , thrombin , platelet , alternative medicine , pathology , mechanical engineering , engineering
Clinical Development Phases I‐III Regulatory, Quality, ManufacturingFor almost six decades, vitamin K antagonists (e.g., warfarin) were the only available oral drugs for the prevention of thromboembolism in patients with atrial fibrillation. Recently, novel oral anticoagulants that target thrombin (dabigatran) or activated factor X (rivaroxaban and apixaban) have successfully completed clinical development and received approval for stroke prevention in atrial fibrillation. Novel oral anticoagulants have been shown to be noninferior, or in some cases superior to warfarin in both safety and efficacy aspects. Their advanced pharmacological properties result to rapid, consistent anticoagulation at fixed dosing without need for laboratory monitoring. As with any antithrombotic therapy, novel oral anticoagulants should be used with caution, for the appropriate clinical indications and with an awareness of their limitations and contraindication.