Current challenges and future prospects in oral anticoagulant therapy
No Thumbnail Available
Authors
Czuprynska, Julia
Patel, Jignesh P.
Arya, Roopen
Check for full-text access
Issue Date
2017
Type
Article
Language
Keywords
Alternative Title
Abstract
The choice for oral anticoagulant (OAC) therapy was previously limited to the vitamin K antagonists (VKAs). The advent of the direct oral anticoagulants (DOACs) brought with it the expectation that oral anticoagulation would become simpler (with the elimination of routine monitoring and introduction of a fixed-dose anticoagulant), and that the use of VKAs would be slowly phased out. Although DOACs have made anticoagulation more convenient and accessible, we are now faced with what can be described as a tyranny of choice, together with many unanswered questions relating to DOAC use. These include optimal DOAC selection and dosing, use in complex 'real-world' patients, the role for monitoring and issues surrounding adherence. Warfarin remains the anticoagulant of choice in certain scenarios (e.g. metallic heart valves). The future holds much excitement: clinical studies are underway to expand the indications for DOACs and experience continues to grow outside the trials setting.
Description
Citation
Publisher
License
Journal
British Journal of Haematology
Volume
178
Issue
6