title: Dabigatran: a new option for anticoagulation in atrial fibrillation and venous thromboembolism.
abstract: For several decades now, oral anticoagulation with warfarin has represented the cornerstone of measures to prevent occurrence of ischemic stroke in high-risk patients with atrial fibrillation. However, the mechanism of action and pharmacokinetic profile of this vitamin K antagonist confers a narrow therapeutic range and makes it prone to drug and dietary interactions, requiring frequent monitoring of its effectiveness. The recently introduced oral direct thrombin antagonist, dabigatran, has been shown in phase III clinical trials to be noninferior in efficacy to warfarin for the prevention of thromboembolic events in patients with atrial fibrillation, as well as in treatment of acute venous thromboembolism. In this article, we review the factors necessitating the development of dabigatran, summarize key clinical trial evidence leading to its approval, and discuss its potential role as an alternative to warfarin in current clinical practice.
authors: Department of Medicine, SUNY at Buffalo School of Medicine, NY, USA.
authors: Subroto
authors: S
authors: Acharjee
authors: Christopher P
authors: CP
authors: Cannon
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D001562:Benzimidazoles / Q000008:administration & dosage / Q000493:pharmacokinetics; D001702:Biopharmaceutics; D001777:Blood Coagulation / Q000187:drug effects*; D017326:Clinical Trials, Phase III as Topic; D000069604:Dabigatran; D017277:Drug Approval; D054796:Drug Dosage Calculations; D016903:Drug Monitoring / Q000379:methods / Q000592:standards; D006801:Humans; D018570:Risk Assessment; D013810:Therapeutic Equivalency; D013917:Thrombin / Q000037:antagonists & inhibitors* / Q000378:metabolism; D013923:Thromboembolism / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000493:pharmacokinetics; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D015091:beta-Alanine; D014859:Warfarin; D013917:Thrombin; D000069604:Dabigatran