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New oral anticoagulants for venous thromboembolism: focus on factor Xa and thrombin inhibitors

Cecilia Becattini1, Alessandra Lignani, Giancarlo Agnelli

  • 1Internal and Cardiovascular Medicine & Stroke Unit, University of Perugia, Perugia, Italy. cecilia.becattini@unipg.it

Current Drug Discovery Technologies
|August 16, 2011
PubMed

Insights

New oral anticoagulants, including anti-Xa agents, show promise for preventing and treating venous thromboembolism (VTE). Clinical trials indicate non-inferiority to standard treatments with similar bleeding risks.

Area of Science:

  • Pharmacology
  • Hematology
  • Clinical Medicine

Background:

  • Several oral direct anti-Xa agents and one antithrombin agent are in clinical development for venous thromboembolism (VTE).
  • Rivaroxaban, apixaban, and dabigatran are licensed for VTE prevention post-orthopedic surgery.
  • Studies on rivaroxaban and apixaban for medical patients' VTE prevention are pending.

Purpose of the Study:

  • To review the current clinical development of oral anticoagulants for VTE prevention and treatment.
  • To summarize findings from Phase III trials on VTE treatment with rivaroxaban and dabigatran.
  • To highlight ongoing clinical trials for other anti-Xa agents in VTE management.

Main Methods:

  • Review of clinical trial data for oral direct anti-Xa agents and antithrombin agents.
  • Analysis of Phase III study results for rivaroxaban and dabigatran in VTE treatment.
  • Summary of ongoing Phase II and III trials for apixaban, edoxaban, and other anti-Xa agents.

Main Results:

  • Rivaroxaban and dabigatran demonstrated non-inferiority to standard treatments for VTE therapy.
  • Major or clinically relevant non-major bleeding rates were comparable between new agents and standard treatments.
  • Apixaban and edoxaban are currently in clinical trials for VTE treatment.

Conclusions:

  • Oral direct anti-Xa agents and antithrombin agents represent a significant advancement in VTE management.
  • Current evidence supports the efficacy and safety of rivaroxaban and dabigatran in VTE treatment.
  • Further research and ongoing trials will clarify the role of various oral anticoagulants in VTE prophylaxis and treatment.

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