Non-vitamin K antagonist oral anticoagulants (NOACs): Clinical evidence and therapeutic considerations

Saraf, Karan, Morris, Paul D., Garg, Pankaj, Sheridan, Paul and Storey, Robert (2014) Non-vitamin K antagonist oral anticoagulants (NOACs): Clinical evidence and therapeutic considerations. Postgraduate Medical Journal, 90 (1067). pp. 520-528. ISSN 0032-5473

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Abstract

Warfarin, a vitamin K antagonist, is the most widely used oral anticoagulant in the world. It is cheap and effective, but its use is limited in many patients by unpredictable levels of anticoagulation, which increases the risk of thromboembolic or haemorrhagic complications. It also requires regular blood monitoring and dose adjustment. New classes of drugs, non-vitamin K antagonist oral anticoagulants (NOACs), are now supported as alternatives to warfarin. Three NOACs are licensed: dabigatran, a direct thrombin inhibitor, and rivaroxaban and apixaban, antagonists of factor Xa. NOACs do not require routine blood monitoring or dose adjustment. They have a rapid onset and offset of action and fewer food and drug interactions. Current indications include treatment and prophylaxis of venous thromboembolism and prevention of cardioembolic disease in non-valvular atrial fibrillation. Effective antidotes are lacking and some caution must be used in severe renal impairment, but favourable trial evidence has led to their widespread adoption. Research is ongoing, and an increase in their use and indications is expected in the coming years.

Item Type: Article
Additional Information: There is a correction for this article, which affects the citation information but not the content of the article (see https://pmj.bmj.com/content/90/1068/575): The second author’s name was published incorrectly. His correct name should be ‘Paul D Morris’ therefore indexed as ‘Morris PD’.
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 08 Dec 2021 11:30
Last Modified: 15 Dec 2021 00:53
URI: https://ueaeprints.uea.ac.uk/id/eprint/82599
DOI: 10.1136/postgradmedj-2014-132605

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