Key result
Target-specific oral anticoagulants are at least as effective as warfarin, often with superior safety for the prevention of stroke in atrial fibrillation and treatment of venous thromboembolism.
Why the study?
Do target-specific oral anticoagulants (TSOACs) prevent stroke in nonvalvular AF and recurrent VTE compared to warfarin?
Do target-specific oral anticoagulants (TSOACs) prevent stroke in nonvalvular AF and recurrent VTE compared to warfarin?
This review highlights that target-specific oral anticoagulants are effective and safe alternatives to warfarin for stroke prevention in AF and VTE management, providing guidance for hospitalists.
Supports TSOAC preference over warfarin in AF and VTE; confirms trial synthesis but leaves real-world implementation open.
As a class, the target-specific oral anticoagulants (TSOACs) are at least as effective as warfarin, often with superior safety for the prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and the treatment of acute venous thromboembolism (VTE) and prevention of recurrent VTE. Currently, dabigatran, the direct thrombin inhibitor, along with rivaroxaban and apixaban, direct factor Xa inhibitors, has been approved in multiple countries for these indications. Edoxaban, which has received approval for the abovementioned indications in Japan, has demonstrated efficacy and safety comparable to or better than warfarin in Phase III clinical trials and is under further regulatory consideration. It is anticipated that the use of TSOACs will increase as practitioners and healthcare systems gain familiarity with these drugs and adopt their use into clinical practice. This review will provide a brief overview of the TSOAC Phase III clinical trials for prevention of stroke and systemic embolic events in patients with AF and the Phase III clinical trials for the prevention of recurrent VTE, discuss current treatment guidelines, address how TSOACs may help meet national safety goals, and provide clinical decision-making guidance regarding the use of TSOACs for hospitalists.
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Deitelzweig et al. (2015) conducted a review in Nonvalvular atrial fibrillation (AF) and venous thromboembolism (VTE). Target-specific oral anticoagulants (TSOACs) vs. Warfarin was evaluated. Target-specific oral anticoagulants are at least as effective as warfarin, often with superior safety for the prevention of stroke in atrial fibrillation and treatment of venous thromboembolism.
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