Modern Treatment Modalities and Duration of Treatment for Venous Thromboembolism.

Abstract

Abstract. Anti-vitamin K (AVK) were the only oral anticoagulants available for the treatment of venous thromboembolism for about half a century until the recent approval of novel oral agents dabigatran, rivoraxaban, apixaban and edoxaban. Randomized phase 3 trials have demonstrated that patients receive similarly effective anticoagulation with the DOACs when compared with warfarin, with similar or reduced risk of bleeding. Extended therapy trials have consistently demonstrated superior effectiveness for DOACs treatment when compared with placebo in preventing VTE recurrence. These new classes of medications are less cumbersome to use and they do not require frequent laboratory monitoring or have numerous drug interactions. Although DOACs allow for simplification of treatment in the majority of patients with acute VTE, they have not been tested in all subgroups of patients. This review summarizes the major trials that led to the approval of these agents, clinical settings or subgroups of patients in whom s...