Dosing of Target-Specific Oral Anticoagulants in Special Populations

Morrill, Amanda M.; Willett, Kristine C.

doi:10.1177/1060028015591846

Cited by 16 publications

(6 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rivaroxaban's onset of action is 30 minutes, faster than the 36-72 hours for warfarin (which requires overlap with heparin therapy). Interactions of NOACs with other drugs are rare, with the exception of a few antibiotics and antifungals, which may be significant for patients with malignancy [ 26 ].…”

Section: Advantages Of Noacs For Vtementioning

confidence: 99%

Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis

Priyanka

Kupec

Krafft

et al. 2018

International Journal of Hepatology

View full text Add to dashboard Cite

Background Newer oral anticoagulants (NOACs) are being utilized increasingly for the treatment of venous thromboembolism (VTE). NOAC use is the standard of care for stroke prophylaxis in nonvalvular atrial fibrillation and treatment of acute VTE involving extremities and pulmonary embolism. In contrast, most guidelines in the literature support the treatment of acute portal vein thrombosis (PVT) with low molecular weight heparin (LMWH) and vitamin K antagonists (VKA). Literature evaluating NOAC use in the treatment of acute portal vein thrombosis is sparse. This review focuses on the safety and efficacy of the use of NOACs in the treatment of acute PVT in patients, with or without concomitant cirrhosis, based on the most recent data available in the current literature. Methods A systematic review was conducted through a series of advanced searches in the following medical databases: PubMed, BioMed Central, Cochrane, and Google Scholar. Keywords utilized were as follows: NOAC, DOAC (direct oral anticoagulants), portal vein thrombosis, rivaroxaban, apixaban, dabigatran, and edoxaban. Articles related to newer anticoagulant use in patients with portal vein thrombosis were included. Results The adverse events, including bleeding events (major and minor) and the failure of anticoagulation (propagation of thrombus or recurrence of PVT), are similar between the NOACs and traditional anticoagulants for the treatment of acute PVT, irrespective of the presence of cirrhosis. Conclusions Newer oral anticoagulants are safe and efficacious alternatives to traditional anticoagulation with low molecular weight heparin and vitamin K antagonists in the treatment of acute portal vein thrombosis with or without cirrhosis.

show abstract

Section: Advantages Of Noacs For Vtementioning

confidence: 99%

Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis

Priyanka

Kupec

Krafft

et al. 2018

International Journal of Hepatology

View full text Add to dashboard Cite

show abstract

“…The percentage of obese patients enrolled was small. In the subgroup studies, the efficacy and the safety of the NOACs in obese patients 53 were good, although the RE-COVER study showed a non-significant trend towards a higher incidence of VTE events in patients with BMI >30 kg/m 2 , 2 these data seem to be in contrast with the results of the Randomized Evaluation of Long-term anticoagulant TherapY study (RE-LY) 56 …”

Section: Disputes About Using Non-vitamin K Dependent New Oral Anticomentioning

confidence: 97%

“…However, the inclusion criteria showed some differences among trials 3 , 7 , 10 , 52 . Regarding chronic RF, due to the different pharmacokinetics of the molecules, that have a specific elimination, an increased incidence of VTE events and bleeding complications during anticoagulant therapy has been documented 53 . Patients with chronic RF have been excluded from the recruitment in the clinical trials evaluating the NOACs.…”

Section: Disputes About Using Non-vitamin K Dependent New Oral Anticomentioning

confidence: 99%

“…Patients with chronic RF have been excluded from the recruitment in the clinical trials evaluating the NOACs. As a result, the current recommendation about the use of NOACs in these groups of patients comes from the analysis of subgroups and from previous pharmacokinetic studies 53 . In short, while in patients with severe RF (Cr Cl < 25–30 mL/min) the NOACs are contraindicated, in patients with moderate RF (Cr Cl 30–50 mL/min) they can be used 54 .…”

Section: Disputes About Using Non-vitamin K Dependent New Oral Anticomentioning

confidence: 99%

See 1 more Smart Citation

ANMCO Position Paper: the use of non-vitamin K dependent new oral anticoagulant(s) in pulmonary embolism therapy and prevention

Enea

Roncon

Gulizia

et al. 2017

European Heart Journal Supplements

View full text Add to dashboard Cite

The new oral anticoagulants (NOACs) have radically changed the approach to the treatment and prevention of thromboembolic pulmonary embolism. The authors of this position paper face, in succession, issues concerning NOACs, including (i) their mechanism of action, pharmacodynamics, and pharmacokinetics; (ii) the use in the acute phase with the ‘double drug single dose’ approach or with ‘single drug double dose’; (iii) the use in the extended phase with demonstrated efficacy and with low incidence of bleeding events; (iv) the encouraging use of NOACs in particular subgroups of patients such as those with cancer, the ones under- or overweight, with renal insufficiency (creatinine clearance > 30 mL/min), the elderly (>75 years); (v) they propose a possible laboratory clinical pathway for follow-up; and (vi) carry out an examination on the main drug interactions, their potential bleeding risk, and the way to deal with some bleeding complications. The authors conclude that the use of NOACs both in the acute phase and in the extended phase is equally effective to conventional therapy and associated with fewer major bleeding events, which make their use in patients at higher risk of recurrences safer.

show abstract

“…Dosing and treatment considerations of these agents have been reviewed previously. 7–9 The purpose of this article was to describe the novel pharmacology and mechanisms of action of the new oral anticoagulants as they relate to their use among solid organ transplant recipients. This will include discussion of dosing in patients with impaired renal and hepatic function, considerations for drug-drug interactions with immunosuppressive medications, and management of patients at the time of unplanned surgery.…”

Section: Introductionmentioning

confidence: 99%

Direct oral anticoagulant considerations in solid organ transplantation: A review

Salerno

Tsapepas

Papachristos

et al. 2016

Clinical Transplantation

View full text Add to dashboard Cite

For more than 60 years, warfarin was the only oral anticoagulation agent available for use in the United States. In many recent clinical trials, several direct oral anticoagulants (DOACs) demonstrated similar efficacy with an equal or superior safety profile, with some other notable benefits. The DOACs have lower inter- and intrapatient variability, much shorter half-lives, and less known drug-drug and drug-food interactions as compared to warfarin. Despite these demonstrated benefits, the use of DOACs has not gained uniform acceptance because of lack of supportive data in special patient populations, including recipients of solid organ transplants maintained on immunosuppression. This review describes the properties of several novel DOACs including their pharmacology and mechanisms of action as they relate to use among solid organ transplant recipients. We have particularly focused on (i) dosing in patients with impaired renal and hepatic function; (ii) considerations for drug-drug interactions with immunosuppressive medications; and (iii) management of the anticoagulated patients at the time of unplanned surgery. The risks and benefits of the use of DOACs in solid organ transplant recipients should be carefully evaluated prior to the introduction of these agents in this highly distinct patient population.

show abstract

Dosing of Target-Specific Oral Anticoagulants in Special Populations

Cited by 16 publications

References 43 publications

Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis

Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis

ANMCO Position Paper: the use of non-vitamin K dependent new oral anticoagulant(s) in pulmonary embolism therapy and prevention

Direct oral anticoagulant considerations in solid organ transplantation: A review

Contact Info

Product

Resources

About