Is there a need for an alternative in the era of novel anticoagulants?

Abstract

With the development of the new direct oral anticoagulants, many of the unmet needs of the vitamin K antagonists were fulfilled, such as the absence of dietary interactions, few drug interactions, predictable effects and no need for monitoring. However, growing experience with the direct oral anticoagulants indicates there is still room for improvement. Developing antithrombotic agents that optimize their antithrombotic effect while producing little or no risk of bleeding is a long sought after goal. This and other enhanced attributes of candidate drugs are on the horizon.

Universal, class-specific and drug-specific reversal agents for the new oral anticoagulants

“…Finally, there has long been evidence that the antithrombotic potential of a drug is not necessarily linked to its ability to impair coagulation (i.e., anticoagulant effect). Thus, improving antithrombotic efficacy while reducing anticoagulant-related bleeding has been a long sought after goal [30]. Compared to the VKAs, the DOACs have furthered this prospect with their reduced bleeding profile.…”