Risk impact of edoxaban in the management of stroke and venous thromboembolism

Vasc Health Risk Manag. 2016 Aug 11:12:329-35. doi: 10.2147/VHRM.S94679. eCollection 2016.

Abstract

The new generation of target-specific oral anticoagulants is being prescribed for increasing numbers of patients at risk of stroke or venous thromboembolism (VTE). These drugs offer valuable benefits due to fast onset anticoagulation, a fixed anticoagulation effect (allowing administration of specified doses), and no requirement for routine monitoring. Edoxaban is a fast-acting oral anticoagulant, approved for use in the prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and in the treatment of acute VTE. Like many of the new oral anticoagulants, it selectively inhibits factor Xa, in a concentration-dependent manner. Multiple Phase II clinical trials have shown edoxaban to be noninferior to vitamin K antagonists in the prevention of stroke and VTE, with a good safety profile. To date, the pivotal studies to endorse edoxaban's clinical use have been ENGAGE AF-TIMI and Hokusai-VTE, both of which have compared its efficacy to standard warfarin treatment. This paper aims at reviewing the use of edoxaban in the management of stroke and thromboembolic disease, highlighting the key study results that have led to its current license.

Keywords: atrial fibrillation; edoxaban; new oral anticoagulants; randomized controlled trials; stroke management; venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Atrial Fibrillation / blood
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Blood Coagulation / drug effects*
  • Factor Xa Inhibitors / administration & dosage*
  • Factor Xa Inhibitors / adverse effects
  • Factor Xa Inhibitors / pharmacokinetics
  • Hemorrhage / chemically induced
  • Humans
  • Pyridines / administration & dosage*
  • Pyridines / adverse effects
  • Pyridines / pharmacokinetics
  • Risk Factors
  • Stroke / blood
  • Stroke / etiology
  • Stroke / prevention & control*
  • Thiazoles / administration & dosage*
  • Thiazoles / adverse effects
  • Thiazoles / pharmacokinetics
  • Treatment Outcome
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control*

Substances

  • Factor Xa Inhibitors
  • Pyridines
  • Thiazoles
  • edoxaban