title: Review of the Target-Specific Oral Anticoagulants in Development for the Treatment and Prevention of Venous Thromboembolism.
abstract: Anticoagulation therapy is often indicated for the treatment and prevention of venous thromboembolism (VTE). Despite advances in anticoagulant management with parenteral anticoagulants and vitamin K antagonists, limitations to their use still exists, leading to investigation of alternative anticoagulants such as factor Xa inhibitors and direct thrombin inhibitors. To date, 3 target-specific oral anticoagulants (TSOACs) are Food and Drug Administration approved; several other agents are currently in development to optimize VTE management and minimize bleeding risks. The objective of this systematic review article is to provide clinicians an overview of the clinical evidence on the investigational TSOACs for the treatment and prevention of VTE. Of the agents in development, edoxaban holds the most promise due to robust data supporting its clinical benefit with a similar bleeding risk to currently approved agents. Clinicians should understand the TSOACs under investigation, since differences in pharmacokinetics and pharmacodynamics may influence clinical decision making and agent selection for management of VTE. Currently, no direct comparisons between TSOACs have been conducted. Agents under investigation have yet to overcome the major limitations of the currently existing TSOACs. Further studies are necessary to clarify which TSOAC agent is best for management of VTE in clinical practice.
authors: Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA sdevabha@rx.umaryland.edu.
authors: Sandeep
authors: S
authors: Devabhakthuni
authors: Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Rockville, MD, USA.
authors: Connie H
authors: CH
authors: Yoon
authors: Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA.
authors: Kathleen J
authors: KJ
authors: Pincus
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D000991:Antithrombins / Q000008:administration & dosage*; D016503:Drug Delivery Systems / Q000379:methods* / Q000639:trends; D065427:Factor Xa Inhibitors / Q000008:administration & dosage*; D006801:Humans; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors
keywords: direct thrombin inhibitors; factor IXa inhibitors; factor Xa antagonists/inhibitors; target-specific oral anticoagulants; venous thromboembolism