title: Pharmacotherapy with oral Xa inhibitors for venous thromboembolism.
abstract: BACKGROUND
  Venous thromboembolism (VTE) causes substantial morbidity and mortality worldwide. The traditional treatment of VTE, with an initial therapy with (low molecular weight) heparin or fondaparinux and a continued treatment with vitamin K antagonists, is effective but has limitations.
  
  
  METHODS
  The current review summarizes the results of the Phase III trials with the new oral direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban and provides a meta-analysis of these trials in the subgroups of elderly patients (> 75 years) and patients with impaired renal function.
  
  
  CONCLUSIONS
  The practical use of direct Xa inhibitors in the treatment of VTE in general and in specific subgroups is discussed. For elderly patients, patients with extremes of body weight, cancer patients or patients with moderate renal impairment, pooled data suggest that the direct oral Xa inhibitors are a reasonable alternative to standard therapy. For other indications, such as treatment of VTE in children, during pregnancy or in the context of heparin-induced thrombocytopenia, further data from clinical trials are needed.
authors.affiliation: KU Leuven - University of Leuven, Vascular Medicine and Haemostasis, Department of Cardiovascular Sciences , Leuven , Belgium Peter.Verhamme@uzleuven.be.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vanassche
authors.forename: Christophe
authors.initials: C
authors.lastname: Vandenbriele
authors.forename: Kathelijne
authors.initials: K
authors.lastname: Peerlinck
authors.forename: Peter
authors.initials: P
authors.lastname: Verhamme
mesh_terms: D000284:Administration, Oral; D017326:Clinical Trials, Phase III as Topic; D015951:Factor Xa / Q000378:metabolism; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D009025:Morpholines / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011728:Pyridones / Q000627:therapeutic use; D000069552:Rivaroxaban; D013844:Thiazoles / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D065427:Factor Xa Inhibitors; D009025:Morpholines; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; D013876:Thiophenes; C522181:apixaban; D000069552:Rivaroxaban; D015951:Factor Xa; C552171:edoxaban
keywords: apixaban; deep vein thrombosis; edoxaban; factor X; oral anticoagulants; pulmonary embolism; rivaroxaban; venous thromboembolism