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Novel Anticoagulants For Drug Discovery | Open Access Journals
Immunochemistry & Immunopathology

Immunochemistry & Immunopathology

ISSN: 2469-9756

Open Access

Novel Anticoagulants For Drug Discovery

DOC is increasingly used for several reasons.44 First is the ease of use with no need for monitoring, no food interactions, and minimal drug interactions. Second, meta-analyses show these agents are as effective or more effective in stroke preventions in AF, equivalent in the treatment of venous thromboembolism, and safer than warfarin. Limited data exist on the utilization of DOACs in pediatric patients, and none of them currently have FDA-approved pediatric labeling. Off-label use of those DOACs in pediatrics is essentially extrapolated from adult dosing guidelines. We will briefly discuss currently available DOACs because we expect their use will increase within the coming years as more data become available for pediatric patients. For non-cancer patients with VTE, large randomized trials have demonstrated that DOACs are at least as effective as treatment with LMWH transitioned to VKA.264–267 One of the main concerns regarding their use in cancer patients is that only a small number of cancer patients were included in these large trials. The Einstein DVT and PE studies, which led to the approval of rivaroxaban as the first approved DOC for the treatment of DVT, included only 462 of 8281 (5.6%) patients with active cancer at baseline.264,268 The Amplify trial, which compared apixaban with enoxaparin followed by warfarin for treatment of acute VTE, included just 3.1% (169 of 5395) with active cancer and 6.8% (365 of 5395) with a history of cancer.

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