News in the Indications of Direct Oral Anticoagulants According to the American College of Chest Physicians 2016 Guidelines

Title:News in the Indications of Direct Oral Anticoagulants According to the American College of Chest Physicians 2016 Guidelines

Volume: 18 Issue: 7

Author(s): Gabriela Cesarman-Maus and Guillermo J. Ruiz-Argüelles*

Affiliation:

• Centro de Hematología y Medicina Interna de Puebla, 8B Sur 3710, 72530 Puebla,Mexico

Keywords: DOAC, NOAC, ACCP, Venous thromboembolic disease, prophylaxis, treatment.

Abstract: Background: The 10th edition of the CHEST Guideline and Expert Panel Report for the treatment of venous thromboembolism (VTE) was recently updated with recommendations on both the choice of anticoagulants and the duration of treatment in diverse clinical scenarios.

Method: In this paper, we focus on news in the use of direct oral anticoagulants (DOACS), a group of synthetic low molecular weight drugs capable of directly and specifically inhibiting either activated factor X or both free and fibrin- bound thrombin.

Results: New to the guidelines is the recommendation of the use of DOACS over vitamin K-antagonists (VKA´s) in individuals without cancer who develop VTE. The choice and intensity of anticoagulants is the same for lower and upper extremity thrombosis or for pulmonary embolism. For cancer-related thrombosis low molecular weight heparin is still recommended over the use of VKA´s or DOACS, though high quality evidence for this choice is lacking. If therapy is given beyond three months, remaining on the same anticoagulant is suggested. Re-thrombosis while on regular use of DOACs requires switching to low molecular weight heparins at least for one month.

Conclusion: Ultimately the choice of anticoagulant will depend on patient–specific factors such as comorbidities, compliance, patient preferences, availability and costs. We address the news in DOAC use in VTE from the perspective of an upper-middle income economy.

Cite this article as:

Cesarman-Maus Gabriela and Ruiz-Argüelles J. Guillermo*, News in the Indications of Direct Oral Anticoagulants According to the American College of Chest Physicians 2016 Guidelines, Current Drug Metabolism 2017; 18 (7) . https://dx.doi.org/10.2174/1389200218666170413154226

DOI https://dx.doi.org/10.2174/1389200218666170413154226	Print ISSN 1389-2002
Publisher Name Bentham Science Publisher	Online ISSN 1875-5453