Treatment of venous thromboembolism in the era of non-vitamin K antagonist oral anticoagulants.

Venous thromboembolism (VTE) is a common cause of cardiovascular morbidity and mortality. Heparins and warfarin have been the standard treatment of VTE for decades, but they have several disadvantages, e.g. parenteral route, narrow therapeutic window and numerous drug interactions. The development of new, non-vitamin K antagonist oral anticoagulants (NOACs) that can overcome these problems is a significant breakthrough and may replace warfarin for treatment of VTE. However, NOACs have some limitations, e.g. the lack of antidotes and high cost. As a result, many physicians are uncomfortable to employ NOACs in daily practice. This review will briefly summarize and update pharmacological profiles, evidence base for VTE treatment from Phase III clinical trials and some clinical considerations of NOACs in treatment of VTE.