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Pharmacological management of pulmonary embolism

Published in Expert Opinion on Pharmacotherapy. 2017, vol. 18, no. 1, p. 79-93
Abstract Pulmonary embolism (PE) is a common and potentially severe manifestation of venous thromboembolism. Its management has relied on anticoagulation by vitamin K antagonists (VKA) for the past fifty years. Recently, new alternative drugs have been developed and dramatically modified both the treatment of acute PE and its secondary prevention. Areas covered: This review discusses the contemporary pharmacological treatment for PE, with a focus on anticoagulation options for non-high risk PE. In particular, the advent of direct oral anticoagulants (rivaroxaban, apixaban, edoxaban and dabigatran) and modalities for long-term prevention will be described. Options for anticoagulation for pregnancy-related PE are presented separately. Expert opinion: Direct oral anticoagulants represent the first-line therapy of non-high risk PE, with better risk-benefit ratios compared with VKA due to lower bleeding risks. In specific groups of patients, however, older generations of anticoagulants such as VKA or heparins still play an important role. Multiple alternatives are available for the secondary prevention of PE, with different efficacies in reducing thrombotic risk and bleeding safety profiles.
Keywords AdministrationOralAnticoagulants/therapeutic useHemorrhage/chemically inducedHumansPulmonary Embolism/drug therapy/prevention & controlSecondary PreventionVenous Thromboembolism/drug therapy
PMID: 27917690
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Research group La maladie thromboembolique veineuse (808)
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GOUIN, Bobby et al. Pharmacological management of pulmonary embolism. In: Expert Opinion on Pharmacotherapy, 2017, vol. 18, n° 1, p. 79-93. doi: 10.1080/14656566.2016.1268122 https://archive-ouverte.unige.ch/unige:99391

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Deposited on : 2017-11-22

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