New anticoagulants

In recent years four new direct action anticoagulants (NOACs) prescribed for the treatment of VTE have become available: rivaroxaban (trading name: Xarelto®), dabigatran (Pradaxa®), apixaban (Eliquis®) and edoxaban (Lixiana®)

These NOACs are administered orally once or twice daily which is more comfortable for the patient. Unlike other anitcoagulant treatments, they do not require routine controls to adjust the dose.

This means lower transportation costs, less time spent for patients and their companions to travel to and fro health centers, as well as reduced hospital stays for low risk patients who continue their treatment at home from day one on. Besides, these drugs barely interfere with food.

The clinical practice guidelines of the American College of Chest Physicians (ACCP) and the Spanish consensus documents for the treatment of PE recommend the use of oral anticoagulants for direct action over vitamin K antagonists in the treatment of patients with VTE.

Random clinical trials have shown that these four drugs present an efficacy similar to the routine treatment (with low molecular weight heparin and antivitamin K), yet being safer. In other words, the same relapses with a lower bleeding rate have been recorded.

However, NOACs are not yet available in all clinical settings.