title: Edoxaban: A direct oral anticoagulant.
abstract: The pharmacology, pharmacokinetics, pharmacodynamics, clinical efficacy, safety, and place in therapy of edoxaban for prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and treatment of venous thromboembolism (VTE) are reviewed.
  
  
  
  Although warfarin has been an established therapy for stroke prevention in AF and VTE, the need for agents with less monitoring requirements, fewer food and drug interactions, and a lower risk of major bleeding led to the development of direct oral anticoagulants (DOACs). Current DOACs work by either directly blocking thrombin (dabigatran) or inhibiting factor Xa (apixaban, edoxaban, and rivaroxaban). Edoxaban is the newest DOAC and only the second Food and Drug Administration-approved anticoagulant for once-daily administration. Unlike apixaban and rivaroxaban, edoxaban does not interact with the cytochrome P-450 system. The results of the ENGAGE AF-TIMI 48 and Hokusai-VTE trials demonstrated edoxaban's noninferiority to warfarin. However, the adverse-effect profile of edoxaban may limit the drug's use in clinical practice; in clinical trials, patients with AF who had a creatinine clearance of ≥95 mL/min had a higher rate of strokes with the use of edoxaban versus warfarin.
  
  
  
  A review of the literature showed that edoxaban, the most recently approved DOAC, is noninferior to warfarin for management of VTE (after parenteral anticoagulant therapy) and for stroke risk reduction in many patients with nonvalvular AF.
authors.affiliation: Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL. mara_poulakos@pba.edu.
authors.forename: Mara
authors.initials: M
authors.lastname: Poulakos
authors.affiliation: Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL.
authors.forename: Jacqueline N
authors.initials: JN
authors.lastname: Walker
authors.affiliation: Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL.
authors.forename: Umima
authors.initials: U
authors.lastname: Baig
authors.affiliation: Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL.
authors.forename: Tosin
authors.initials: T
authors.lastname: David
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D016903:Drug Monitoring / Q000379:methods; D065427:Factor Xa Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D011725:Pyridines / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013844:Thiazoles / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D011725:Pyridines; D013844:Thiazoles; D014859:Warfarin; C552171:edoxaban
keywords: AFib; DU-176b; Savaysa; VTE prophylaxis; atrial fibrillation; edoxaban; factor Xa inhibitor