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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
New anticoagulants for atrial fibrillation
Magdalena Sobieraj-Teague1, Martin O'Donnell, John Eikelboom
1McMaster University, Hamilton, Ontario, Canada. teaguem@mcmaster.ca
Seminars in Thrombosis and Hemostasis
|September 10, 2009
Summary
New anticoagulants targeting factor IIa or Xa are being developed to replace vitamin K antagonists for stroke prevention in atrial fibrillation (AF). These agents offer predictable dosing and are in phase III trials, with no approvals yet.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Atrial fibrillation (AF) is a prevalent cardiac arrhythmia and a significant risk factor for stroke.
- Vitamin K antagonists (VKAs) are effective anticoagulants for stroke prevention in AF but have limitations.
- Numerous novel anticoagulant therapies are under investigation to overcome VKA limitations.
Purpose of the Study:
- To review the development of new anticoagulant agents for stroke prevention in patients with atrial fibrillation.
- To compare the characteristics and clinical trial status of novel oral anticoagulants (NOACs) and a new vitamin K antagonist.
Main Methods:
- Review of current and investigational anticoagulant drugs for atrial fibrillation.
- Focus on small molecule inhibitors targeting Factor IIa and Factor Xa.
- Summary of phase III clinical trial data comparing new agents with established therapies.
Main Results:
- Several novel anticoagulants targeting Factor IIa (e.g., dabigatran etexilate) and Factor Xa (e.g., rivaroxaban, apixaban) are in phase III clinical trials.
- These agents offer predictable pharmacokinetics, enabling fixed dosing without laboratory monitoring.
- A novel vitamin K antagonist (ATI-5923) with improved properties is also in phase III evaluation.
Conclusions:
- New anticoagulant drugs show promise for stroke prevention in atrial fibrillation.
- These agents aim to improve upon the efficacy and usability of current therapies.
- No new anticoagulant agents have received regulatory approval for clinical use to date.
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