Oral anticoagulation therapy: An update on usage, costs and associated risks

Oral anticoagulant therapy (OAT) is prescribed for various reasons,1e3 and now includes several agent classes.Vitamin K antagonists (VKAs), including warfarin, represent classical oral anticoagulants and remain commonly used for treatment of venous thromboembolism (VTE) [including deep vein thrombosis (DVT) and pulmonary embolism (PE)], stroke prophylaxis in atrial fibrillation (AF), and to reduce the risk of prosthetic heart valve thrombosis and thromboembolism. More recent availability of direct inhibitors of either thrombin (factor IIa) or activated factor X (FXa), have transformed the OAT landscape as representing ‘direct oral anticoagulants’ (or DOACs),sometimes referred to as ‘non Vitamin K antagonist oral anticoagulants’ (or NOACs). Here, we update the use, costs and some associated risks related to OAT.