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New developments in anticoagulants: Past, present and future.

Jeffrey I Weitz1, Job Harenberg

  • 1Jeffrey I. Weitz, 237 Barton St E, Hamilton, Ontario L8L 2X2, Canada, Tel.: +1 905 574 8550,

Thrombosis and Haemostasis
|June 9, 2017
PubMed
Summary

Anticoagulant therapies have advanced significantly, with new drugs like non-vitamin K antagonist oral anticoagulants (NOACs) offering improved safety and convenience over older treatments. Research continues into novel anticoagulants and their specific reversal agents for enhanced patient care.

Keywords:
Thrombosisanticoagulantheparinlow-molecular-weight heparinnon-vitamin K antagonist oral anticoagulantwarfarin

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Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Pharmacology

Background:

  • Thrombosis poses a significant global health risk, necessitating effective anticoagulant therapies.
  • Traditional anticoagulants include unfractionated heparin (UFH) and vitamin K antagonists (VKAs).
  • Recent advancements have introduced safer and more convenient anticoagulant options.

Purpose of the Study:

  • To highlight recent advances in anticoagulant therapies.
  • To discuss the role of specific reversal agents for novel oral anticoagulants (NOACs).
  • To review ongoing clinical trials and emerging anticoagulant targets.

Main Methods:

  • Review of current literature on anticoagulant drug development and clinical use.
  • Analysis of the advantages of low-molecular-weight heparin, fondaparinux, and bivalirudin over UFH.
  • Examination of the efficacy, safety, and convenience of NOACs (dabigatran, rivaroxaban, apixaban, edoxaban) compared to VKAs.

Main Results:

  • Low-molecular-weight heparin and fondaparinux have largely replaced UFH for venous thromboembolism prevention and treatment.
  • Bivalirudin is increasingly used in percutaneous interventions.
  • NOACs demonstrate comparable efficacy to VKAs with improved safety and convenience, leading to their wider adoption.

Conclusions:

  • The landscape of anticoagulant therapy has evolved, offering improved options for patients.
  • Development of specific reversal agents for NOACs is expected to further enhance their safety profile.
  • Emerging anticoagulants targeting Factor XII and XI represent future therapeutic avenues.