Content area
Full Text
Published online: 6 November 2015
© Springer International Publishing Switzerland 2015
Abstract Edoxaban (Lixiana®, Savaysa®) is an oral, direct factor Xa inhibitor which has recently been approved for use in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) [collectively, venous thromboembolism (VTE)] and for the prevention of recurrent VTE. This article reviews the pharmacological properties of edoxaban as well as its tolerability and therapeutic efficacy in the treatment and prevention of recurrent VTE events. As demonstrated in the pivotal Hokusai-VTE phase III trial, once-daily edoxaban after initial treatment with heparin was non-inferior to standard therapy with heparin/ warfarin in preventing recurrent VTE events and was associated with a significantly lower risk of clinically relevant bleeding than the traditional therapy. Edoxaban shares the advantages of other direct oral anticoagulants (DOACs) over traditional therapies, including the lack of requirement for routine coagulation monitoring, a rapid onset and offset of action, and few drug-drug interactions. It offers the convenience of once-daily dosing, can be taken without regard to food and allows for a dose reduction in patients with certain clinical features, such as moderate renal impairment or low body weight. In conclusion, edoxaban represents an effective and potentially safer alternative to traditional vitamin K antagonist therapy for the treatment and prevention of recurrent VTE. Its recent approval expands the range of DOAC agents for recurrent VTE, further facilitating treatment individualization.
1 Introduction
Venous thromboembolism (VTE), which encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of morbidity and mortality worldwide [1-3]. With an annual incidence of approximately 1-3 new cases per 1000 individuals, VTE represents a significant health concern [3]. Moreover, VTE can be considered a chronic disease as patients who survive a first VTE episode have an elevated risk of a recurrent event [1, 4, 5]. The risk of recurrence is highest during the first weeks and months following the incident event and declines thereafter [4-6]. Around 30 % of patients experience a recurrent event within 10 years of an initial VTE episode [1, 4, 5].
The cornerstone of VTE therapy, both for the treatment of an acute episode as well as for the prevention of recurrent events, is anticoagulation [6, 7]. For many years, the standard approach has...