title: Role of Direct Oral Anticoagulants in the Management of Anticoagulation.
abstract: For decades, vitamin K antagonists (VKAs) have been the oral treatment of choice for many thromboembolic conditions. The limitations of VKAs include the need for monitoring through blood testing, drug interactions, and narrow therapeutic windows. These shortcomings have led to the development of direct oral anticoagulants. These new oral agents act on specific targets in the coagulation cascade (eg, factor Xa, thrombin) and negate some of the shortcomings of VKAs. This article reviews the roles of dabigatran, rivaroxaban, apixaban, and edoxaban in stroke prevention in nonvalvular atrial fibrillation, for prevention of venous thromboembolism after orthopedic surgery, and in the treatment of venous thromboembolism. Direct oral anticoagulants are at least as efficacious and safe as traditional anticoagulation therapy.
authors.affiliation: From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, and the University of Oklahoma Health Sciences Center, Oklahoma City.
authors.forename: Rajiv N
authors.initials: RN
authors.lastname: Thakkar
authors.affiliation: From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, and the University of Oklahoma Health Sciences Center, Oklahoma City.
authors.forename: Suman W
authors.initials: SW
authors.lastname: Rathbun
authors.affiliation: From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, and the University of Oklahoma Health Sciences Center, Oklahoma City.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wright
mesh_terms: D000208:Acute Disease / Q000628:therapy; D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods; D001777:Blood Coagulation / Q000187:drug effects; D006801:Humans; D020521:Stroke / Q000517:prevention & control; D013923:Thromboembolism / Q000188:drug therapy*; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D000925:Anticoagulants