DIRECT ORAL ANTICOAGULANTS: A NEW PARADIGM IN DEEP VEIN THROMBOSIS TREATMENT

  • Bruna Guimarães Faculty of Medicine, University of Porto, Porto
  • Luciana Ricca Gonçalves Serviço de Imunohemoterapia, Centro Hospitalar de São João, Faculdade de Medicina da Universidade do Porto, Porto
  • Armando Mansilha Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar de São João, Faculdade de Medicina da Universidade do Porto, Porto
Keywords: Direct oral anticoagulants, Deep vein thrombosis, Dabigatran, Rivaroxaban, Apixaban, Edoxaban

Abstract

The deep vein thrombosis (DVT) is a high morbility pathology if not properly diagnosed and treated at its aerly stage. The direct oral anticoagulants (doacs), which selectly inhibit factor IIa (dabigatran) or factor Xa (rivaroxaban, apixaban and edoxaban), have become an attractive alternative to conventional therapy due to their fixed doses, no food interactions and absence of monitoring. 

The aim of this wrk is to procced with a revision on therapeutic use of DOACs and their risk/benefit correlation in comparison to conventional therapy in the DVT treatment and prevention. 

It was conducted a search on Pubmed database of English-language articles that addressed the DOACs in treatment and secondary prevention of DVT. It were also included the major cinica trials and the atest guidelines for the treatment and prevention of Venous Thromboembolism (VTE).

Large randomized studies sateted the non-inferiority of DOACs in the efficiency profile in comparison to conventional therapy, with the adventage of providing a higher safety profile. The improved risk/benefir ratio of DOACs combined with predictable pharmacokinetic properties and the absence of monitoring allow a better relation cost/efficiency.

Athough not all patients benefit from this therapy, which should be individualized in each case, the DOACs have changed DVT treatment and prevention into a more practical and safer procedure, associated with a higher patient satisfaction and a decrease in recurrent events incidence, lauching a new paradigm in DVT treatment and prevention.

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Published
2017-07-17
Section
Review Article