[Dabigatran: transforming the management of oral anticoagulation]

The utility of oral anticoagulation with warfarin in thromboembolic disease has been demonstrated for several decades, although these drugs have significant problems in terms of adequate control, interactions and risk of bleeding. In the last decade, new anticoagulants have emerged. The first was dabigatran with a demonstrated anticoagulant effect approaching the ideal anticoagulant profile. The view that dabigatran transforms oral anticoagulation therapy has arisen from the RE-VOLUTION program, with more than 34000 patients analyzed. This program has confirmed the value of oral anticoagulation with dabigatran compared with other anticoagulants; this drug eliminates all the drawbacks of warfarin, benefitting both patients and the healthcare system. The growth of the aging population has increased the number of risk situations in which anticoagulation is used. There is now a drug that meets the criteria for the ideal anticoagulant, transforming the management of oral anticoagulation. The findings demonstrated with dabigatran in prior studies are progressively being transferred to clinical practice. Following the usual development of new drugs, and according to the latest Laurence Desmond stages, results in agreement with those of previous studies are expected, namely, indisputable improvements in oral anticoagulation for patients and the health system.