Abstract
For patients requiring long-term anticoagulation, oral vitamin K antagonists (VKAs) such as warfarin have overwhelming efficacy data and present significant challenges. In addition to the potential exposure to numerous drug-drug and drug-food interactions, patients receiving warfarin require frequent monitoring. It had been hoped that the integration of pharmacogenomic with clinical information would improve anticoagulation control with warfarin, but trials have not supported this aim. Novel oral anticoagulants (NOACs) offer both advantages and disadvantages and deserve consideration in appropriate patients.
MeSH terms
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Administration, Oral
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Anticoagulants / pharmacokinetics
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Anticoagulants / therapeutic use*
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Antithrombins / pharmacokinetics
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Antithrombins / therapeutic use
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Aryl Hydrocarbon Hydroxylases / genetics
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Atrial Fibrillation / complications
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Atrial Fibrillation / drug therapy
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Benzimidazoles / pharmacokinetics
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Benzimidazoles / therapeutic use*
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Cytochrome P-450 CYP2C9
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Dabigatran
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Factor Xa Inhibitors
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Genotype
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Humans
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Morpholines / pharmacokinetics
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Morpholines / therapeutic use*
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Pharmacogenetics
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Polymorphism, Genetic
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Pyrazoles / pharmacokinetics
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Pyrazoles / therapeutic use*
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Pyridones / pharmacokinetics
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Pyridones / therapeutic use*
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Randomized Controlled Trials as Topic
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Rivaroxaban
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Stroke / etiology
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Stroke / prevention & control
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Thiophenes / pharmacokinetics
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Thiophenes / therapeutic use*
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Vitamin K Epoxide Reductases / genetics
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Warfarin / pharmacokinetics
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Warfarin / therapeutic use*
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beta-Alanine / analogs & derivatives*
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beta-Alanine / pharmacokinetics
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beta-Alanine / therapeutic use
Substances
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Anticoagulants
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Antithrombins
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Benzimidazoles
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Factor Xa Inhibitors
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Morpholines
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Pyrazoles
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Pyridones
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Thiophenes
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beta-Alanine
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apixaban
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Warfarin
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Rivaroxaban
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CYP2C9 protein, human
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Cytochrome P-450 CYP2C9
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Aryl Hydrocarbon Hydroxylases
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VKORC1 protein, human
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Vitamin K Epoxide Reductases
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Dabigatran