DOA and Venous Thromboembolic Disease

Abstract

The prevention and the treatment of Venous
Thromboembolic Disease (VTE) remains a clinical challenge, mainly due to associated complications linked to
the use of heparins and vitamin K antagonists (AVK) in a
growing and increasingly older population.
Direct oral anticoagulants (DOA), such as factor Xa
inhibitors (apixaban, edoxaban and rivaroxaban), and the
thrombin inhibitor (dabigatran) were studied in phase III
trials in a strategy with three phases : acute phase, long
term and extended period. These agents have proven to be
a simplified treatment, with a similar benefit in terms of
antithrombotic efficacy and a significantly better benefit
in terms of bleeding safety compared to the reference
treatment associating heparins with AVK. Based on data
from randomized trials and "real life" registries, this
review summarized the clinical outcomes of DOAs in secondary prevention and treatment of VTE, focusing on the
net benefit and various limitations of their use in this context which is often complex.