New anticoagulant drugs for treatment of venous thromboembolism and stroke prevention in atrial fibrillation

Abstract.  Tripodi A, Palareti G (IRCCS Ca Granda Maggiore Hospital Foundation and Universita degli Studi di Milano, Milano, Italy; S.Orsola-Malpighi University Hospital, Bologna, Italy). New anticoagulant drugs for treatment of venous thromboembolism and stroke prevention in atrial fibrillation (Review). J Intern Med 2012; 271: 554–565. Venous thromboembolism (including deep vein thrombosis and pulmonary embolism) and atrial fibrillation are common conditions in Western countries. The mainstay of treatment and prevention for these diseases is fast-acting anticoagulant drugs such as heparins and vitamin K antagonists. The use of these drugs is, however, complex and demanding for both patients and physicians. Recently, new antithrombotic drugs that act directly by inhibiting activated coagulation factors such as factor X or thrombin have been developed and investigated in phase III clinical trials. The aim of this article is to review: (i) the need to develop new drugs; (ii) their efficacy/safety as demonstrated in clinical trials; (iii) the need for laboratory monitoring and (iv) the direction towards the use of these new drugs in the real-life clinical situation.