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Published on: February 28, 2012
Novel oral anticoagulants
C W Khoo1, K-H Tay, E Shantsila
1University Department of Medicine, City Hospital, Birmingham, England, UK.
International Journal of Clinical Practice
|February 19, 2009
Summary
New oral anticoagulants offer alternatives to warfarin for preventing blood clots and stroke. These novel drugs, including direct thrombin and factor Xa inhibitors, aim for stable effects without frequent monitoring.
Area of Science:
- Pharmacology
- Thromboprophylaxis
- Drug Development
Background:
- Vitamin K antagonists (VKAs) like warfarin are established oral anticoagulants for venous thromboembolism and stroke prevention.
- VKAs exhibit significant inter- and intra-individual variability, necessitating regular monitoring and interacting with food and drugs.
- Limitations of VKAs create an unmet need for oral anticoagulants with predictable pharmacokinetics and pharmacodynamics, eliminating the need for monitoring.
Purpose of the Study:
- To review the pharmacology of novel oral anticoagulants (NOACs).
- To summarize recent clinical trial data on NOACs in advanced development.
- To highlight the potential of NOACs as alternatives to VKAs.
Main Methods:
- Literature review of pharmacological data.
- Analysis of published clinical trial results for NOACs.
- Categorization of NOACs into direct thrombin and factor Xa inhibitors.
Main Results:
- Novel oral anticoagulants represent two main classes: direct thrombin inhibitors and factor Xa inhibitors.
- Emerging clinical data suggest NOACs offer potential advantages over VKAs.
- The review covers NOACs in advanced stages of clinical development.
Conclusions:
- NOACs address the limitations of VKAs, offering predictable anticoagulant effects.
- These newer agents may reduce the need for routine monitoring in anticoagulation therapy.
- Further clinical data will define the role of NOACs in thromboprophylaxis and stroke prevention.
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