Abstract

GUIMARAES, Bruna; GONCALVES, Luciana Ricca  and  MANSILHA, Armando. Direct oral anticoagulants: a new paradigmin deep vein thrombosis treatment. Angiol Cir Vasc [online]. 2017, vol.13, n.2, pp.62-81. ISSN 1646-706X.

The deep vein thrombosis (DVT) is a high morbility pathology if not properly diagnosed and treated at its early-stage. The direct oral anticoagulants (DOACs), which selectly inhibit factor lla (dabigratan) or factor Xa (rivaroxaban, apixaban and edoxaban), have become an attractive alternative to conventional therapy due to their fixed doses, no food interactions and absence of monitoring. The aim of this work is to procced with a revision on the therapeutic use of DOACs and their risk/benefit correlation in comparison to conventional therapy in the DVT treatment and prevention. It was conducted a search on Pubmed database of English-language articles that addressed the DOACs in treatment and secondary prevention of DVT. It were also included the major clinical trials and the latest guidelines for the treatment and prevention of Venous Thromboembolism (VTE). Large randomized studies stated the non-inferiority of DOACs in the efficiency profile in comparison to conventional therapy, with the advantage of providing a higher safety profile. The improved risk/benefit ratio of DOACs combined with predictable pharmacokinetic properties and the absence of monitoring allow a better relation cost/efficiency. Although not all patients benefit from this therapy, which should be individualized in each case, the DOACs have changed DVT treatment and prevention into a more practical and safer procedure, associated with a higher patient satisfaction and a decrease in recurrent events incidence, launching a new paradigm in DVT treatment and prevention.

Keywords : Direct oral anticoagulants; Deep vein thrombosis; Dabigatran; Rivaroxaban; Apixaban; Edoxaban.

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