title: Pharmacodynamics, pharmacokinetics and clinical efficacy of apixaban in the treatment of thrombosis.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a common disorder. Heparin and vitamin K antagonists have been the standard treatment for VTE for over 50 years. The development of apixaban and other direct oral anticoagulants has greatly increased the range of anticoagulants available for the treatment of VTE.
  
  
  METHODS
  Studies on the chemistry, pharmacodynamics and pharmacokinetics of apixaban are reviewed. Its clinical efficacy and safety are discussed, with an emphasis on randomized controlled Phase III clinical trials on treatment of thrombosis.
  
  
  CONCLUSIONS
  Apixaban is a safe and effective anticoagulant for VTE treatment. It has several attractive features: its oral activity, rapid action, limited drug- interaction profile and limited need for laboratory monitoring. An antidote may become available in the near future. Further studies of certain patient populations such as patients with cancers, elderly (aged 75 years and older) and those with severe renal and liver disease, are required as these patients have not yet been studied in sufficient numbers. As clinical trials included only selected patients, data from these studies may not reflect the 'real-life' patients in clinical practice. There is therefore an unmet need for large post-registration studies of unselected 'real-life' patients, such as registry studies, to validate the clinical trial findings.
authors.affiliation: a Department of Haematology , St George Hospital , Kogarah , Australia.
authors.forename: Shiying Silvia
authors.initials: SS
authors.lastname: Zheng
authors.affiliation: b School of Medicine , University of Sydney , Sydney , Australia.|c Westmead Millennium Institute for Medical Research and Department of Cardiology , Westmead Hospital , Sydney , Australia.
authors.forename: James J H
authors.initials: JJ
authors.lastname: Chong
authors.affiliation: a Department of Haematology , St George Hospital , Kogarah , Australia.|d Department of Haematology , Sutherland Hospital , Sydney , Australia.|e St George Clinical School , University of New South Wales , Sydney , Australia.
authors.forename: Beng Hock
authors.initials: BH
authors.lastname: Chong
mesh_terms: D000368:Aged; D000925:Anticoagulants; D017326:Clinical Trials, Phase III as Topic; D016903:Drug Monitoring / Q000379:methods; D065427:Factor Xa Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D011720:Pyrazoles / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D011728:Pyridones / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013927:Thrombosis / Q000188:drug therapy; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D006493:Heparin
keywords: Anti-factor Xa; apixaban; oral anticoagulant; venous thrombo-embolism