Anticoagulation Treatment Using NOAC in Patients with Venous Thromboembolism

ABSTRACT

The results of trials using novel or non-vitamin K-dependent new oral anticoagulants (NOACs) in the treatment of venous thromboembolism (VTE) reveal that these agents are non-inferior (in terms of efficacy) and possibly safer (particularly in terms of major bleeding) than the standard heparin/vitamin K antagonist (VKA) regimen. High TTR values were achieved under VKA treatment in all trials; however, it should be noted that the study populations comprised relatively young patients, very few of whom had cancer. At present, NOACs can be viewed as an alternative to standard treatment. Currently, experience with NOACs is limited, but continues to be accumulated. Practical recommendations for the use of NOACs in different clinical scenarios and the management of their bleeding complications are needed. The results of the trials using NOACs in the extended treatment of VTE are in line with those of the studies that tested these agents for acute-phase treatment and standard duration of anticoagulation after pulmonary embolism (PE) or VTE. They indicate that NOACs are both, effective (in terms of prevention of symptomatic or fatal recurrence of VTE) and safe (particularly in terms of major bleeding), probably safer than standard VKA regimens.