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Review: An overview and analysis of novel oral anticoagulants and their dental implications
Author(s) -
Fortier Kevin,
Shroff Deepti,
Reebye Uday N.
Publication year - 2018
Publication title -
gerodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 54
eISSN - 1741-2358
pISSN - 0734-0664
DOI - 10.1111/ger.12327
Subject(s) - medicine , dabigatran , idarucizumab , edoxaban , rivaroxaban , apixaban , intensive care medicine , medline , warfarin , atrial fibrillation , political science , law
Background Dabigatran, rivaroxaban, apixaban and edoxaban are approved novel oral anticoagulants (NOACs) as alternatives to Vitamin K antagonists (VKA). Physicians are prescribing an ever‐increasing amount these drugs to their patients due to various advantages over existing medications. Aims The objective of this review is to provide the dental professional with current literature surrounding the emergence of NOACs, as well as various case studies on the subject, in an effort to guide clinical decision making regarding these medications. The pharmacological profiles of these NOACs and idarucizumab, a reversal agent for dabigatran, will be detailed in this review. Materials and methods A review of the literature on NOACs was undertaken and the Pubmed, Medline, and Embase databases were used to identify articles published in the English language. Additionally, major dental medicine journals were hand searched, followed by a review of the ClinicalTrials.gov database. Results Due to minimal research regarding dental treatment of patients on NOACs and minimal clinical experience of practitioners treating these patients, there is currently insufficient data to establish an evidence‐based NOAC management protocol in a dental setting. Discussion In this review, the most significant advantages of NOACs over VKAs was found to be limited interactions with other drugs as well as rapid onset and offset of action. Conclusion Despite these benefits, as well as various others, NOACs still lack specific management parameters as well as antidotes or reversal agents. Therefore, dental professionals must use caution when treating patients currently taking these specific anticoagulants.