New anticoagulants: how to deal with treatment failure and bleeding complications
New anticoagulants: how to deal with treatment failure and bleeding complications
Conventional anticoagulants have proven efficacy in the management of thromboembolism. Their adverse effects and a narrow therapeutic window, necessitating regular need for monitoring, however, have long been an incentive for the development of safer anticoagulants without compromising efficacy. Over the last decade or so several new parenteral and oral anticoagulants have been launched with efficacy comparable with conventional agents. From fondaparinux to its long acting derivative idraparinux, and the factor Xa inhibitor rivaroxaban to the direct thrombin inhibitor dabigatran, the advent of new anticoagulants is radically changing anticoagulation. For conventional anticoagulants, despite their shortcomings, effective methods of reversing their anticoagulant effects exist. Moreover, strategies to deal with the occurrence of fresh thrombotic events in the face of therapeutic anticoagulation with the conventional agents have also been addressed. Nevertheless, for the new anticoagulants, the optimal management of these complications remains unknown. This review explores these issues in the light of current evidence.
bleeding complications, dabigatran, new anticoagulants, rivaroxaban, treatment failure
593-603
Kazmi, Rashid S.
b31ef6bd-7f85-439d-ae28-8d097a7b8a41
Lwaleed, Bashir A.
e7c59131-82ad-4a14-a227-7370e91e3f21
October 2011
Kazmi, Rashid S.
b31ef6bd-7f85-439d-ae28-8d097a7b8a41
Lwaleed, Bashir A.
e7c59131-82ad-4a14-a227-7370e91e3f21
Abstract
Conventional anticoagulants have proven efficacy in the management of thromboembolism. Their adverse effects and a narrow therapeutic window, necessitating regular need for monitoring, however, have long been an incentive for the development of safer anticoagulants without compromising efficacy. Over the last decade or so several new parenteral and oral anticoagulants have been launched with efficacy comparable with conventional agents. From fondaparinux to its long acting derivative idraparinux, and the factor Xa inhibitor rivaroxaban to the direct thrombin inhibitor dabigatran, the advent of new anticoagulants is radically changing anticoagulation. For conventional anticoagulants, despite their shortcomings, effective methods of reversing their anticoagulant effects exist. Moreover, strategies to deal with the occurrence of fresh thrombotic events in the face of therapeutic anticoagulation with the conventional agents have also been addressed. Nevertheless, for the new anticoagulants, the optimal management of these complications remains unknown. This review explores these issues in the light of current evidence.
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e-pub ahead of print date: 9 September 2011
Published date: October 2011
Keywords:
bleeding complications, dabigatran, new anticoagulants, rivaroxaban, treatment failure
Organisations:
Faculty of Health Sciences
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Local EPrints ID: 347869
URI: http://eprints.soton.ac.uk/id/eprint/347869
ISSN: 0306-5251
PURE UUID: b8a059b2-3c4a-4cea-b4a6-58e124990eee
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Date deposited: 31 Jan 2013 15:15
Last modified: 06 Aug 2024 01:39
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Author:
Rashid S. Kazmi
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