[Direct oral anticoagulants : therapeutic breakthroughs over the past decade]

In the past decade atrial fibrillation (AF) and venous thromboembolic disease (VTE) treatment have been revolutionized by direct oral anticoagulants (DOACs). Compared to vitamin K antagonists, DOACs have interesting advantages : standardized dosages (no need for monitoring), fast action, short half-life, (no food interaction and lower risk of intracranial bleeding). In addition to VTE and AF, DOACs have specific indications : prevention of postorthopedic surgery VTE and more recently, prevention of cardiovascular events in patients with stable coronaropathy and/or peripheral artery disease. Nevertheless, DOACs must be handled with care according to dosage regimens, contra-indications, drug-drug interactions. Other anticoagulants are in the pipeline. What will their indications be ? Future will tell us.