Related Experiment Video
Updated: May 24, 2026
11:17
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Apixaban: an oral direct factor-xa inhibitor
David Jiménez1, Roger D Yusen, Eduardo Ramacciotti
1Respiratory Department, Ramón y Cajal Hospital, Madrid, Spain. djc_69_98@yahoo.com
Advances in Therapy
|February 23, 2012
Summary
Apixaban, a direct factor Xa inhibitor, shows promise for preventing stroke in atrial fibrillation patients and is approved for venous thromboembolism prophylaxis. However, it carries high bleeding risks in acute coronary syndrome and medically ill patients.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Hematology
Background:
- Apixaban is a direct, selective, and reversible factor Xa inhibitor.
- It offers a predictable pharmacokinetic profile and improved bleeding profile compared to warfarin, without requiring routine monitoring.
- Current approvals include venous thromboembolism (VTE) prophylaxis post-hip or knee replacement in several regions.
Purpose of the Study:
- To evaluate the efficacy and safety of apixaban in various clinical settings.
- To assess its potential as an alternative anticoagulant to warfarin and aspirin.
- To investigate its role in stroke prevention in atrial fibrillation and VTE treatment.
Main Methods:
- Review of completed and ongoing phase 3 clinical trials.
- Analysis of pharmacokinetic and pharmacodynamic data.
- Comparison of apixaban with existing anticoagulants like warfarin and enoxaparin, and antiplatelet agents.
Main Results:
- Apixaban demonstrates promise for stroke prevention in atrial fibrillation, with one trial showing a survival benefit.
- It is approved for VTE prophylaxis in specific surgical patients.
- High bleeding rates were observed when used with dual antiplatelet therapy in acute coronary syndrome and in medically ill patients compared to enoxaparin.
Conclusions:
- Apixaban is a promising oral anticoagulant for atrial fibrillation and VTE prophylaxis.
- Its use in acute coronary syndrome and extended thromboprophylaxis in medically ill patients requires caution due to bleeding risks.
- Further data from ongoing trials will clarify its role in treating deep vein thrombosis and pulmonary embolism.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:16Clot Retraction and Fibrinolysis
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.