6533b7cffe1ef96bd1259974
RESEARCH PRODUCT
Pharmacokinetics of new oral anticoagulants: implications for use in routine care
Corrao SalvatorePiera CapranzanoYlenia IngrasciottaAnna Sveva MancusoGianluca TrifiròIlaria MarcianòSalvatore CrisafulliGiuseppe AndòValeria Pizzimentisubject
medicine.medical_treatmentnew oral anticoagulantsAdministration OralKnee replacement030204 cardiovascular system & hematologyToxicologyAdherence Bleeding Interactions New oral anticoagulants Over- and under-dosage Persistence Pharmacokinetics Real World Evidence0302 clinical medicineAtrial Fibrillationover- and underdosage030212 general & internal medicinepharmacokineticStrokeRoutine careRandomized Controlled Trials as Topicnew oral anticoagulantAtrial fibrillationpersistenceVenous ThromboembolismGeneral MedicinePulmonary embolismStrokepharmacokineticsHumanmusculoskeletal diseasesmedicine.medical_specialtyinteractionHemorrhageMedication Adherence03 medical and health sciencesPharmacokineticsmedicineHumansReal World EvidenceIn patientOver- and under-dosagecardiovascular diseasesreal-world evidenceIntensive care medicineAgedPharmacologybusiness.industryAnticoagulantAnticoagulantsinteractionsbleedingmedicine.diseaseAdherencePulmonary EmbolismbusinessVenous thromboembolismdescription
Introduction: Since 2008, new oral anticoagulants (NOACs) have been approved for the prevention of venous thromboembolism (VTE) in patients receiving hip or knee replacement surgery, prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF), treatment of deep vein thrombosis (DVT), and pulmonary embolism (PE). Premarketing randomized clinical trials (RCTs) of NOACs demonstrated their non-inferiority in terms of efficacy vs. warfarin (traditional oral anticoagulant–TOA), with lower risk of serious adverse drug reactions, especially cerebral hemorrhages. In clinical practice, pharmacokinetic aspects of NOACs have to be carefully taken into account to optimize the benefit-risk profile of these drugs. Areas covered: An overview of major issues related to pharmacokinetics of NOACs, such as drug–drug interactions, over- and underdosage in special populations (e.g. elderly, underweight, and chronic kidney disease patients), and impact on adherence and persistence to NOACs therapy and ultimately clinical outcomes in real-world setting, is provided. Expert opinion: NOACs have been proven to be a better option than traditional anticoagulants due to better tolerability and ease of use. However, given specific pharmacokinetic characteristics, NOAC therapy has to be carefully tailored and monitored in relation to patient characteristics with the final goal of maximizing benefits and minimizing risks.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 | Expert Opinion on Drug Metabolism & Toxicology |