title: Clinical management of rivaroxaban-treated patients.
abstract: BACKGROUND
  Until recently, only vitamin K antagonists (VKAs) were used for long-term anticoagulation. New oral anticoagulants, with pharmacokinetic and pharmacodynamic characteristics different to VKAs, are now available for some indications. Rivaroxaban (Xarelto®) is an oral Factor Xa inhibitor approved in many countries for long-term treatment of patients with atrial fibrillation or venous thromboembolism. This article is addressed to all professionals involved in the management of treated patients to highlight the characteristics of rivaroxaban and provide practical guidance on management of treated patients.
  
  
  METHODS
  This article is based on a consensus of specialists involved in the management of anticoagulant treatment, including thrombosis experts, cardiologists, neurologists, emergency medicine specialists, and general practitioners. The authors performed a nonsystematic review of the literature, and expressed guidance statements based on the results of the review as well as personal experience.
  
  
  CONCLUSIONS
  Availability of new anticoagulant drugs, including rivaroxaban, is an important step forward to allow easier, more effective, and safer long-term anticoagulation in patients in whom adequate anticoagulation is currently denied due to the limitations of VKAs. However, given their totally new properties, associated risks, and expected broad clinical use, expert professionals and manufacturers must urgently tackle a series of issues.
authors: University Hospital of Bologna, Department Angiology and Blood Coagulation, Via Albertoni 15, 40138 Bologna, Italy. gualtiero.palareti@unibo.it
authors: Gualtiero
authors: G
authors: Palareti
authors: Walter
authors: W
authors: Ageno
authors: Annamaria
authors: A
authors: Ferrari
authors: Alessandro
authors: A
authors: Filippi
authors: Davide
authors: D
authors: Imberti
authors: Vittorio
authors: V
authors: Pengo
authors: Andrea
authors: A
authors: Rubboli
authors: Danilo
authors: D
authors: Toni
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood / Q000188:drug therapy*; D001777:Blood Coagulation / Q000187:drug effects; D032921:Consensus; D004347:Drug Interactions; D057915:Drug Substitution; D015951:Factor Xa / Q000378:metabolism; D065427:Factor Xa Inhibitors; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D055118:Medication Adherence; D009025:Morpholines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D000069552:Rivaroxaban; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D009025:Morpholines; D010975:Platelet Aggregation Inhibitors; D013876:Thiophenes; D000069552:Rivaroxaban; D015951:Factor Xa