The pharmacokinetics of edoxaban for the prevention and treatment of venous thromboembolism.
BACKGROUND
Thromboembolic diseases will become the most important contributors to mortality and morbidity for modern societies. Current antithrombotic strategies using heparins or vitamin K antagonists are inconvenient, with limitations and inherent side effects. A series of new oral anticoagulants with powerful and reliable antithrombotic actions have been developed in the last decade.


METHODS
Edoxaban is a direct and specific inhibitor of activated factor X, delivered orally. This article reviews literature from PubMed and articles referenced within. The text explores the pharmacological aspects of its antithrombotic action. Pharmacokinetics, metabolism and drug interactions are examined. The review places the results of recent clinical trials that have evaluated the antithrombotic potential of edoxaban versus standard antithrombotic therapies in the prophylaxis and treatment of venous thromboembolism into perspective. The possible relationship between the pharmacokinetic profile of edoxaban and the favorable results in clinical trials is discussed.


CONCLUSIONS
Edoxaban is perceived as a major advance, compared to vitamin K antagonists, in the prevention and treatment of thromboembolic disease given its favorable efficacy, safety, pharmacokinetic profile and renal clearance. The results of ongoing large international trials exploring the prevention of thrombotic complications in patients in different clinical settings should ensure the approval of edoxaban to treat new indications.
Universitat de Barcelona, Hematologist, Hospital Clinic, Servicio de Hemoterapia y Hemostasia , Villarroel 170, 08036 Barcelona , Spain 34 93 227 54 00 Ext: 2571 ; 34 93 227 93 69 ; gescolar@clinic.ub.es.
Gines
G
Escolar
Maribel
M
Diaz-Ricart
Eduardo
E
Arellano-Rodrigo
Ana M
AM
Galán
D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000493:pharmacokinetics* / Q000627:therapeutic use; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D065427:Factor Xa Inhibitors / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D011725:Pyridines / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013844:Thiazoles / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D011725:Pyridines; D013844:Thiazoles; C552171:edoxaban