title: New anticoagulants: moving on from scientific results to clinical implementation.
abstract: Vitamin K antagonists (VKA) are the only registered oral anticoagulants for the treatment of venous thromboembolism (VTE). VKA have an unpredictable and highly variable effect on coagulation, with a high risk of under- and over-treatment. Novel anticoagulants, such as dabigatran and rivaroxaban, could be a very welcome replacement for VKA, as they show a predictable anticoagulant effect. Results of several phase II and III studies have shown the efficacy and safety of dabigatran and rivaroxaban in the prophylaxis and treatment of VTE, and for the prevention of stroke in atrial fibrillation. It remains to be shown whether these new anticoagulants have the same safety profile in daily clinical practice, where more vulnerable patients will be treated. Lack of information on the proper monitoring method or antidote in case of bleeding may also hinder the translation from science to clinical practice.
authors.affiliation: Department of Vascular Medicine, Academic Medical Centre ,  Amsterdam ,  the Netherlands.
authors.forename: Elise S
authors.initials: ES
authors.lastname: Eerenberg
authors.forename: Josien
authors.initials: J
authors.lastname: van Es
authors.forename: Meertien K
authors.initials: MK
authors.lastname: Sijpkens
authors.forename: Harry R
authors.initials: HR
authors.lastname: Büller
authors.forename: Pieter W
authors.initials: PW
authors.lastname: Kamphuisen
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy; D000925:Anticoagulants / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D001281:Atrial Fibrillation / Q000150:complications; D001562:Benzimidazoles / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D000069604:Dabigatran; D004032:Diet; D004347:Drug Interactions; D015942:Factor VIIa / Q000008:administration & dosage; D065427:Factor Xa Inhibitors; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008019:Life Style; D008991:Monitoring, Physiologic; D009025:Morpholines / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000008:administration & dosage; D000069552:Rivaroxaban; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013876:Thiophenes / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D015091:beta-Alanine / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D009025:Morpholines; D011994:Recombinant Proteins; D013876:Thiophenes; D015091:beta-Alanine; D014812:Vitamin K; D000069552:Rivaroxaban; C103587:recombinant FVIIa; D015942:Factor VIIa; D000069604:Dabigatran