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Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban.

Camm, AJ; Fox, KAA (2018) Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban. Curr Med Res Opin, 34 (11). pp. 1945-1957. ISSN 1473-4877 https://doi.org/10.1080/03007995.2018.1467885
SGUL Authors: Camm, Alan John

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Abstract

BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) have been approved for use in various cardiovascular indications. The direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors apixaban, edoxaban, and rivaroxaban are now increasingly used in clinical practice. For some of these agents, available data from real-world studies support the efficacy and safety data in phase III clinical trials. OBJECTIVES: This review aims to summarize the current status of trials and observational studies of oral anticoagulant use over the spectrum of cardiovascular disorders (excluding venous thrombosis), provide a reference source beyond stroke prevention for atrial fibrillation (AF) and examine the potential for novel applications in the cardiovascular field. METHODS: We searched the recent literature for data on completed and upcoming trials of oral anticoagulants with a particular focus on rivaroxaban. RESULTS: Recent data in specific patient subgroups, such as patients with AF undergoing catheter ablation or cardioversion, have led to an extended approval for rivaroxaban, whereas the other NOACs have ongoing or recently completed trials in this setting. However, there are unmet medical needs for several arterial thromboembolic-related conditions, including patients with: AF and acute coronary syndrome, AF and coronary artery disease undergoing elective percutaneous coronary intervention, coronary artery disease and peripheral artery disease, implanted cardiac devices, and embolic stroke of unknown source. CONCLUSION: NOACs may provide alternative treatment options in areas of unmet need, and numerous studies are underway to assess their benefit-risk profiles in these settings.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Current Medical Research and Opinion on 19/4/18, available online: http://www.tandfonline.com/10.1080/03007995.2018.1467885
Keywords: direct oral anticoagulant, factor Xa inhibitor, lifecycle management, rivaroxaban, General & Internal Medicine, 11 Medical And Health Sciences, 14 Economics
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Curr Med Res Opin
ISSN: 1473-4877
Language: eng
Dates:
DateEvent
21 May 2018Published
19 April 2018Published Online
18 April 2018Accepted
Publisher License: Publisher's own licence
PubMed ID: 29672182
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109789
Publisher's version: https://doi.org/10.1080/03007995.2018.1467885

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