Article
Cardiac & Cardiovascular Systems
Nijole Bernaitis, Tony Badrick, Shailendra Anoopkumar-Dukie
Summary: This study found that when patients with atrial fibrillation were switched from warfarin to a non-vitamin K oral anticoagulant (NOAC), the potential for pharmacokinetic (PK) drug interactions significantly reduced but remained around 40%. Identifying and managing potential PK drug interactions with NOACs remains a priority to optimize the clinical benefit of these anticoagulants.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Review
Biochemistry & Molecular Biology
Angela Saviano, Mattia Brigida, Carmine Petruzziello, Marcello Candelli, Maurizio Gabrielli, Veronica Ojetti
Summary: NOACs are a safer alternative to warfarin for the prevention and treatment of thromboembolic cardiovascular conditions. Studies have shown that apixaban has a lower rate of gastrointestinal bleeding compared to dabigatran and rivaroxaban, and gastrointestinal bleeding in patients treated with NOACs is generally less severe than with warfarin. The use of NOACs is increasing and widespread in patients who require anticoagulation, with an overall lower risk of major bleeding events. However, caution is still needed in patients at high risk of gastrointestinal bleeding.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Medicine, General & Internal
Ajinkya Pawar, Joshua J. Gagne, Chandrasekar Gopalakrishnan, Geetha Iyer, Helen Tesfaye, Gregory Brill, Kristyn Chin, Katsiaryna Bykov
Summary: This study compares the outcomes of VTE patients using different drugs for oral anticoagulation therapy beyond 90 days, including hospitalization for recurrent VTE, major bleeding, and death. The results show that continuation of apixaban therapy beyond 90 days is associated with a significantly lower rate of recurrent VTE hospitalization compared to warfarin, but no significant difference is found between apixaban and rivaroxaban. There is no significant difference in the rate of hospitalization for major bleeding among the three drugs.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2022)
Article
Hematology
Ramin Artang, Camille Brod, Jorn Dalsgaard Nielsen
Summary: This study examined the effect of direct oral anticoagulants (DOACs) on commercially available conventional TEG 5000 assays and a novel modified assay. The results showed that the TEG 5000 can effectively monitor the DOAC effect on hemostasis. Further clinical studies are needed for correlation with clinical outcomes.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2022)
Article
Biochemistry & Molecular Biology
Georges Jourdi, Johan Abdoul, Virginie Siguret, Xavier Decleves, Elisa Frezza, Claire Pailleret, Isabelle Gouin-Thibault, Sophie Gandrille, Nathalie Neveux, Charles Marc Samama, Samuela Pasquali, Pascale Gaussem
Summary: This study investigated the effect of induced forms of alpha 2M on anticoagulant drugs, revealing that GDFXa-induced alpha 2M can neutralize dabigatran and heparins in blood, and may be developed as a universal antidote.
INTERNATIONAL JOURNAL OF BIOLOGICAL MACROMOLECULES
(2021)
Review
Biochemistry & Molecular Biology
Natalia A. Shnayder, Marina M. Petrova, Pavel A. Shesternya, Alina V. Savinova, Elena N. Bochanova, Olga V. Zimnitskaya, Elena A. Pozhilenkova, Regina F. Nasyrova
Summary: DOACs, such as dabigatran, rivaroxaban, apixaban, and edoxaban, are commonly used for thromboembolism prevention in various medical fields. The importance of genetic information for predicting pharmacokinetics and risk in patients receiving anticoagulant therapy is increasingly recognized.
Article
Medicine, General & Internal
Woldesellassie M. Bezabhe, Jan Radford, Barbara C. Wimmer, Mohammed S. Salahudeen, Ivan Bindoff, Gregory M. Peterson
Summary: The use of DOACs is associated with a lower risk of osteoporosis compared to warfarin, with each individual DOAC having a significantly lower risk as well.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Medicine, General & Internal
David Mocini, Stefania Angela Di Fusco, Edoardo Mocini, Lorenzo Maria Donini, Carlo Lavalle, Andrea Di Lenarda, Carmine Riccio, Pasquale Caldarola, Leonardo De Luca, Michele Massimo Gulizia, Fabrizio Oliva, Domenico Gabrielli, Furio Colivicchi
Summary: DOACs, including dabigatran, rivaroxaban, apixaban, and edoxaban, offer major advantages over VKAs, but concerns remain regarding potential undertreatment in obese patients without specific RCTs comparing the two. Despite limitations, the Italian Association of Hospital Cardiologists has proposed recommendations for the use of DOACs in obese patients based on existing evidence.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Cardiac & Cardiovascular Systems
Robert Benamouzig, Maxime Guenoun, David Deutsch, Laurent Fauchier
Summary: There is no significant difference in major gastrointestinal bleeding risk between DOACs and VKAs. Gastrointestinal bleeding in DOAC-treated patients appears to be less severe and requires less intensive management. The main causes of gastrointestinal bleeding in DOAC-treated patients differ between upper and lower gastrointestinal bleeding.
CARDIOVASCULAR DRUGS AND THERAPY
(2022)
Article
Hematology
Lenna Ord, Toomas Marandi, Marit Mark, Leonid Raidjuk, Jelena Kostjuk, Valdas Banys, Karit Krause, Marika Pikta
Summary: This study evaluated the uses and limitations of the DOAC Dipstick for detecting DOACs in urine and compared visual analysis and DOASENSE Reader analysis of the Dipstick pads. The results showed that the DOAC Dipstick can detect DOACs in urine at a plasma concentration threshold of >= 30 ng/mL.
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
(2022)
Review
Pharmacology & Pharmacy
Maryam Daei, Hossein Khalili, Zinat Heidari
Summary: Based on limited available data, dabigatran showed the least excretion in human breast milk, while rivaroxaban and dabigatran had acceptable levels of milk excretion, and apixaban exceeded the maximum allowed range. Further well-designed studies with larger sample sizes are necessary to provide consistent and comparable data to clarify the benefits and risks of each DOAC during breastfeeding.
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Article
Medicine, General & Internal
Margaret C. Fang, Kristi Reynolds, Dongjie Fan, Priya A. Prasad, Sue Hee Sung, Cecilia Portugal, Elisha Garcia, Alan S. Go
Summary: In this cohort study of VTE patients on extended warfarin or DOAC anticoagulation, DOAC treatment was associated with a lower risk of recurrent VTE, supporting the use of DOACs for extended VTE treatment in terms of clinical outcomes.
Article
Medicine, General & Internal
Gregory Y. H. Lip, Allison Keshishian, Yan Zhang, Amiee Kang, Amol D. Dhamane, Xuemei Luo, Christian Klem, Mauricio Ferri, Jenny Jiang, Huseyin Yuce, Steven Deitelzweig
Summary: In this study of patients with NVAF and high risk of GI bleed, NOACs were associated with lower rates of stroke and/or SE, but NOACs had varying risks of MB compared with warfarin. These results may help inform treatment options in this patient population.
Article
Medicine, General & Internal
Kevin M. Wheelock, Joseph S. Ross, Karthik Murugiah, Zhenqiu Lin, Harlan M. Krumholz, Rohan Khera
Summary: Despite the increasing use of DOAC among Medicare beneficiaries, many clinicians in the study continued to prefer warfarin over DOACs as their primary or only anticoagulant. Addressing barriers to the uptake of these medications is necessary to realize their potential benefits for patients.
Article
Cardiac & Cardiovascular Systems
M. Jansson, S. Sjalander, V Sjogren, F. Bjorck, H. Renlund, B. Norrving, A. Sjalander
Summary: This study compared the effectiveness and safety of reduced-dose direct oral anticoagulants (DOACs) and high-quality warfarin treatment in nonvalvular atrial fibrillation patients. The findings showed that compared to warfarin, DOACs have lower risks of major bleeding and all-cause stroke, with the exception of rivaroxaban, which has a higher risk of major bleeding and a lower risk of stroke or systemic embolism. Therefore, in patients with indications for reduced-dose DOACs, they are the preferred treatment option.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2023)