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Update on Edoxaban for the Prevention and Treatment of Thromboembolism: Clinical Applications Based on Current Evidence

机译:Edoxaban预防和治疗血栓栓塞的最新进展:基于当前证据的临床应用

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摘要

Vitamin K antagonists (VKA) and heparins have been utilized for the prevention and treatment of thromboembolism (arterial and venous) for decades. Targeting and inhibiting specific coagulation factors have led to new discoveries in the pharmacotherapy of thromboembolism management. These targeted anticoagulants are known as direct oral anticoagulants (DOACs). Two pharmacologically distinct classes of targeted agents are dabigatran etexilate (Direct Thrombin Inhibitor (DTI)) and rivaroxaban, apixaban, and edoxaban (direct oral factor Xa inhibitors (OFXaIs)). Emerging evidence from the clinical trials has shown that DOACs are noninferior to VKA or low-molecular-weight heparins in the prevention and treatment of thromboembolism. This review examines the role of edoxaban, a recently approved OFXaI, in the prevention and treatment of thromboembolism based on the available published literature. The management of edoxaban in the perioperative setting, reversibility in bleeding cases, its role in cancer patients, the relevance of drug-drug interactions, patient satisfaction, financial impacts, and patient education will be discussed.
机译:数十年来,维生素K拮抗剂(VKA)和肝素已被用于预防和治疗血栓栓塞(动脉和静脉)。靶向和抑制特定的凝血因子已导致血栓栓塞治疗的药物治疗中的新发现。这些靶向抗凝剂称为直接口服抗凝剂(DOAC)。两种在药理学上不同的靶向药物是达比加群酯(直接凝血酶抑制剂(DTI))和利伐沙班,阿哌沙班和依多沙班(直接口服Xa因子抑制剂(OFXaIs))。临床试验的新证据表明,在预防和治疗血栓栓塞症方面,DOAC不劣于VKA或低分子量肝素。这篇综述基于现有的公开文献,研究了最近批准的OFXaI edoxaban在预防和治疗血栓栓塞中的作用。将讨论围手术期使用依多沙班的管理,出血病例的可逆性,其在癌症患者中的作用,药物相互作用的相关性,患者满意度,财务影响和患者教育。

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