Experience with non-vitamin K antagonists in the Netherlands: stories from both sides of the desk

摘要

In the prevention of thromboembolic complications in patients with atrial fibrillation non-vitamin K antagonist oral anticoagulants (NOACs) are not only as effective as vitamin K antagonists (VKAs), but also have the advantage that they less frequently cause major bleeding events, in particular fewer intracranial haemorrhages [ – ]. Another important advantage of NOACs over VKAs: less variability in anticoagulant response, mainly caused by fewer food-drug and drug-drug interactions [ ]. Due to this lower variability, a fixed dosing regimen applies to NOACs, obviating the need of routine monitoring of anticoagulant activity. This in contrast to treatment with VKAs [ ]. However, this lack of monitoring may come with new challenges and downsides, namely more inappropriate dosing and non-adherence [ ].