Edoxaban in the prevention and treatment of thromboembolic complications from a clinical point of view

Edoxaban is an oral once-daily factor Xa inhibitor with a predictable anticoagulant effect. After oral administration, edoxaban is rapidly absorbed from the gastrointestinal tract, reaching the peak plasma concentrations at 1-2 h. Oral bioavailability is 62% in healthy subjects and the terminal half-life is approximately 10-14 h. Edoxaban has been extensively studied in three clinical scenarios. In ENGAGE AF-TIMI 48, edoxaban was at least as effective as warfarin, but with a marked lesser risk of bleeding. In the Hokusai-VTE study, edoxaban was as effective as warfarin for the prevention of recurrent venous thromboembolism (VTE) in patients with deep venous thrombosis, pulmonary embolism, or both, but with a lesser risk of bleeding. In the STARS program, edoxaban was more effective for the prevention of VTE after knee or hip arthroplasty than low-dose enoxaparin, without an increased bleeding risk. In this review, the available clinical evidence about edoxaban is updated.