title: Management of Venous Thromboembolism: Recent Advances in Oral Anticoagulation Therapy.
abstract: To review clinical data on direct oral anticoagulants (DOACs) used in the acute treatment of venous thromboembolism (VTE) as well as practical considerations when using these products.
  
  
  
  Searches of PubMed and Google Scholar for VTE, deep vein thrombosis, pulmonary embolism, and relevant drug international nonproprietary names were conducted. Additional online searches were conducted for prescribing information.
  
  
  
  Relevant articles on dabigatran, rivaroxaban, apixaban, and edoxaban for the management of VTE compared with oral vitamin K antagonists (VKAs; published between 1966 and December 2015) were reviewed and summarized, together with information on dosing, pharmacokinetics/pharmacodynamics, and drug-drug interactions.
  
  
  
  The DOACs have the potential to circumvent many of the disadvantages of VKAs. At a minimum, they greatly increase the available therapeutic options, thus providing a greater opportunity for clinicians to select a management option that best fits the needs of individual patients. Despite the significant advance that DOACs represent, they are not without risk and require careful consideration of a number of clinical issues to optimize safety and efficacy.
  
  
  
  The emergence of DOACs for the management of thromboembolic disorders represents a paradigm shift from oral VKAs. The DOACs provide similar efficacy and improved safety in selected patients as compared with VKAs. Clinicians treating VTE need to be familiar with the intricacies involved in using these agents, including the appropriate dose selection for the relevant indication, avoidance of drug-drug and drug-disease interactions, and consideration of dose adjustments in specific clinical situations, such as organ dysfunction.
authors.affiliation: University of Tennessee, Memphis, TN, USA sfinks@uthsc.edu.
authors.forename: Shannon W
authors.initials: SW
authors.lastname: Finks
authors.affiliation: University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Toby C
authors.initials: TC
authors.lastname: Trujillo
authors.affiliation: University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Dobesh
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000069604:Dabigatran / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D004347:Drug Interactions; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy*; D011720:Pyrazoles / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D011725:Pyridines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D011728:Pyridones / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000069552:Rivaroxaban / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D013844:Thiazoles / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran; C552171:edoxaban
keywords: apixaban; dabigatran; deep vein thrombosis; direct oral anticoagulants; edoxaban; pulmonary embolism; rivaroxaban; target-specific oral anticoagulants; venous thromboembolism