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Anticoagulation in sub‐Saharan Africa: Are direct oral anticoagulants the answer? A review of lessons learnt from warfarin
Author(s) -
Semakula Jerome Roy,
Kisa Geraldine,
Mouton Johannes P.,
Cohen Karen,
Blockman Marc,
Pirmohamed Munir,
SekaggyaWiltshire Christine,
Waitt Catriona
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14796
Subject(s) - warfarin , medicine , atrial fibrillation , intensive care medicine , clinical trial , anticoagulant , venous thromboembolism , stroke (engine) , rivaroxaban , surgery , thrombosis , mechanical engineering , engineering
Warfarin has existed for >7 decades and has been the anticoagulant of choice for many thromboembolic disorders. The recent introduction of direct‐acting oral anticoagulants (DOACs) has, however, caused a shift in preference by healthcare professionals all over the world. DOACs have been found to be at least as effective as warfarin in prevention of stroke in patients with atrial fibrillation and in treatment of venous thromboembolism. In sub‐Saharan Africa, however, the widespread use of DOACs has been hampered mainly by their higher acquisition costs. As the drugs come off patent, their use in sub‐Saharan Africa is likely to increase. However, very few trials have been conducted in African settings, and safety concerns will need to be addressed with further study before widespread adoption into clinical practice.