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Abstract
Traditional anticoagulants such as heparin and vitamin K antagonists have been the mainstay of antithrombotic therapy for many years. However, these drugs have a number of well-recognized drawbacks: unfractionated heparin, low molecular weight heparins and fondaparinux are administered parenterally, and vitamin K antagonists require routine coagulation monitoring. Novel, single-target oral anticoagulants have been developed that do not need routine coagulation monitoring, including the direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban, and the direct thrombin inhibitor dabigatran. Rivaroxaban is the most advanced in its clinical development. Across all ten Phase III/IV trials, rivaroxaban met the primary efficacy end points and generally had similar incidences of bleeding, with a comparable safety profile to standard-of-care.
Acknowledgements
The author acknowledges L Wan, who provided editorial support with funding from Bayer HealthCare Pharmaceuticals and Janssen Scientific Affairs, LLC.
Financial & competing interests disclosure
S Schellong is a member of advisory boards for Boehringer, Bayer, Daiichi Sankyo, Leo Pharmaceuticals and Sanofi-aventis, and has received speaker’s honoraria from Boehringer, Bayer HealthCare, Bristol-Myers Squibb, Daiichi Sankyo, Leo Pharmaceuticals, Pfizer and Sanofi-aventis. S Schellong does not hold any stocks, nor has he received any research grants. S Schellong received editorial support funded by Bayer HealthCare Pharmaceuticals and Janssen Scientific Affairs, LLC. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.