[New oral anticoagulants: emerging clinical data and role of the primary care physician].
New oral anticoagulants offer several potential advantages including oral administration, fixed doses, no regular coagulation monitoring and dose adjustment and wide therapeutic index. The results from clinical studies for prevention and treatment of venous thromboembolism and for stroke prevention in patients with atrial fibrillation show that these agents are at least as effective as or superior to currently available therapies depending on the molecules and dose regimen. Physicians will have to make choices among available new agents taking into account their pharmacokinetic properties, half-life, route of elimination and patient comorbidities. But the use of these new agents in daily practice raises some issues such as temporary discontinuation in patients undergoing invasive procedures and management of patients with bleeding in the absence of specific antidote. New oral anticoagulants should be used with caution in daily practice in special populations such as elderly patients, patients with renal impairment and patients with cancer. Primary care physicians will have to play a role in monitoring and evaluating the long-term efficacy and safety of these agents in daily practice.
Service de Pathologie Vasculaire, Hôpital Erasme, Bruxelles. serge.motte@erasme.ulb.ac.be
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D000284:Administration, Oral; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D010819:Physician's Role; D058007:Physicians, Primary Care; D054556:Venous Thromboembolism / Q000517:prevention & control
D000925:Anticoagulants