Contexts for proscribing and not prescribing DOAs

Abstract

DOA indications are major with atrial fibrillation,
venous thromboembolic disease and high risk orthopedic
surgery. In fact, many clinical situations remain contraindicated for the use of DOA. Within a population with
the right indication, patient profiles may not not be eligible for DOA use. It is therefore important to respect these
limitations of use while awaiting more convincing results
and demonstrating the benefit of this therapeutic choice.
Today the misuse of DOAs is responsible for failure with
performance below those of clinical trials validating their
indication. The double penalty is also to be exposed to a
hemorrhagic over-risk. One must see right and prescribed
right without extrapolating in a simplistic way to areas
not yet validated by clinical trials or registry data.