UNIGE document Scientific Article - Review
previous document  unige:74012  next document
add to browser collection
Title

Direct oral anticoagulants: efficacy and safety in patient subgroups

Authors
Published in Swiss Medical Weekly. 2015, vol. 145, p. w14081
Abstract Direct oral anticoagulants have recently emerged as an attractive choice for patients requiring anticoagulation treatment. They have a rapid onset of action and can be administered at fixed doses without the need for routine anticoagulation monitoring. They may present fewer interactions than warfarin but further experience is needed to assess the clinical significance of the interactions with cytochrome CYP3A and P-gp inhibitors/inducers. A higher rate of bleeding has been observed in association with antiplatelet agents or non-steroidal anti-inflammatory drugs. Their safety profile has not been sufficiently studied in the elderly, and in patients with liver disease or severe renal impairment. Dose adjustment is necessary in patients with moderate renal impairment and a higher bleeding rate has been observed in this subgroup, although not higher than with warfarin. The clinical settings that require monitoring of coagulation assays have not yet been specified. Reversal of their anticoagulant effect may be problematic in case of severe bleeding. Therefore, despite the obvious advantages of the direct oral anticoagulants, experience is still lacking for many patient subgroups in which they should be withheld awaiting more data.
Identifiers
PMID: 25658756
Full text
Article (Published version) (472 Kb) - public document Free access
Structures
Research groups Geneva Platelet Group (13)
Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) (585)
Groupe Desmeules Jules (pharmacologie/toxicologie) (567)
Citation
(ISO format)
MAVRAKANAS, Thomas et al. Direct oral anticoagulants: efficacy and safety in patient subgroups. In: Swiss Medical Weekly, 2015, vol. 145, p. w14081. https://archive-ouverte.unige.ch/unige:74012

180 hits

116 downloads

Update

Deposited on : 2015-07-08

Export document
Format :
Citation style :