title: Current management of venous thromboembolism in Japan: Current epidemiology and advances in anticoagulant therapy.
abstract: Venous thromboembolism (VTE), manifesting as either deep vein thrombosis or pulmonary embolism, is common worldwide including in Japan. The number of patients clinically diagnosed with VTE is increasing with the majority of cases occurring out-of-hospital and of milder severity. Cancer is the largest risk factor for VTE and VTE in cancer patients confers an increased 1-year mortality rate. However, the majority of VTE cases are considered "idiopathic" or "unprovoked." The limited efficacies of unfractionated heparin and warfarin have stimulated the development of new anticoagulant therapies. Recently, parenteral and oral administration of the Xa inhibitors fondaparinux and edoxaban, respectively, was approved in Japan. These agents have the potential to provide safer and more efficacious treatment options for VTE. Although further randomized studies are required to validate the utility of these agents, they are expected to substantially improve quality of life in VTE patients. This review summarizes the current status of VTE management in Japan focusing on current epidemiology and recent advances in anticoagulant therapy.
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan; Center for Pulmonary Embolism and Venous Thrombosis, Murase Hospital, Suzuka, Japan. Electronic address: mashio@clin.medic.mie-u.ac.jp.
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D000077425:Fondaparinux; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011134:Polysaccharides / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000188:drug therapy; D011725:Pyridines / Q000627:therapeutic use*; D011788:Quality of Life; D012307:Risk Factors; D013844:Thiazoles / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000188:drug therapy; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D011134:Polysaccharides; D011725:Pyridines; D013844:Thiazoles; D014859:Warfarin; D006493:Heparin; D000077425:Fondaparinux; C552171:edoxaban
keywords: Anticoagulation; Deep vein thrombosis; Nonvitamin K antagonist oral anticoagulant; Pulmonary embolism; Venous thromboembolism