Why the study?
Do novel anticoagulants (FXa inhibitors and direct thrombin inhibitors) provide effective and safe alternatives to vitamin K antagonists for the prevention and treatment of thromboembolic diseases?
Do novel anticoagulants (FXa inhibitors and direct thrombin inhibitors) provide effective and safe alternatives to vitamin K antagonists for the prevention and treatment of thromboembolic diseases?
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Novel anticoagulants, including FXa and direct thrombin inhibitors, offer effective and safe alternatives to vitamin K antagonists for thromboembolic disease management without the need for regular monitoring.
Vitamin K antagonists are the mainstay in the prevention and treatment of thromboembolic diseases. Although effective under optimal conditions, several drawbacks are imminent to the long-term application of these drugs due to their narrow therapeutic window, interactions with other drugs as well as the need for regular monitoring and the risk of a recurrent event versus the risk of bleeding. To overcome these downsides, novel anticoagulants are being developed; in contrast to vitamin K antagonists, these novel agents specifically and selectively block central elements of the coagulation cascade. Several clinical trials have demonstrated the efficacy and safety of selective FXa inhibitors (such as fondaparinux, rivaroxaban, apixaban) and direct thrombin inhibitors (such as lepirudin, bivalirudin, dabigatran etexilate) in the treatment of typical indications for conventional vitamin K antagonists, in particular, the prevention and treatment of venous thromboembolism. This review summarizes the results and designs of recently published and ongoing clinical trials of novel anticoagulants.
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Steffel et al. (2009) studied this question.
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