title: Bleeding with direct oral anticoagulants vs warfarin: clinical experience.
abstract: The risk of bleeding in the setting of anticoagulant therapy continues to be re-evaluated following the introduction of a new generation of direct oral anticoagulants (DOACs). Interruption of DOAC therapy and supportive care may be sufficient for the management of patients who present with mild or moderate bleeding, but in those with life-threatening bleeding, a specific reversal agent is desirable. We review the phase 3 clinical studies of dabigatran, rivaroxaban, apixaban, and edoxaban in patients with nonvalvular atrial fibrillation, in the context of bleeding risk and management.
authors.affiliation: Department of Medicine, Division of Hematology and Thromboembolism, McMaster University, Hamilton, Ont, Canada. Electronic address: eikelbj@mcmaster.ca.
authors.forename: John
authors.initials: J
authors.lastname: Eikelboom
authors.affiliation: Departments of Surgery and Medicine, Jefferson Vascular Center, Thomas Jefferson University Hospitals, Philadelphia, PA.
authors.forename: Geno
authors.initials: G
authors.lastname: Merli
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D017326:Clinical Trials, Phase III as Topic; D000069604:Dabigatran / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D011720:Pyrazoles / Q000009:adverse effects; D011725:Pyridines / Q000009:adverse effects; D011728:Pyridones / Q000009:adverse effects; D000069552:Rivaroxaban / Q000009:adverse effects; D013844:Thiazoles / Q000009:adverse effects; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; C522181:apixaban; D014859:Warfarin; D000069552:Rivaroxaban; D000069604:Dabigatran; C552171:edoxaban