Novel oral anticoagulants: What dermatologists need to know

Plovanich, Molly; Mostaghimi, Arash

doi:10.1016/j.jaad.2014.11.013

Cited by 27 publications

(12 citation statements)

References 55 publications

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“…Warfarin has been known to cause an acquired form of protein C deficiency by inhibiting synthesis of clotting factors II, VII, IX and X, as well as the regulatory factors proteins C and S 1. A rare complication of warfarin therapy includes skin necrosis that affects 0.01%–0.1% of patients, with a female:male ratio of 1:4 2 3.…”

Section: Discussionmentioning

confidence: 99%

Anticoagulation therapy for thromboembolism prevention: a case of warfarin-induced skin necrosis in the setting of protein C deficiency

et al. 2017

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Patients with protein C deficiency are at increased risk for thrombolic diseases. Non-vitamin K antagonist anticoagulant options should be considered in patients with warfarin-induced skin necrosis (WISN) in the setting of protein C. We report a 41-year-old African American male patient with WISN and protein C deficiency who was treated with rivaroxaban followed by dabigatran. After 1 month on rivaroxaban, he began experiencing blood in his stools, unrelenting pain in his lower extremities, found it difficult to obtain medication despite having insurance and as a result did not maintain compliance. He was then assessed at the hospital, symptomatically treated and discharged on dabigatran. After 6 weeks, he reported symptomatic relief and less side effects. This case involved a head-to-head clinical comparison of rivaroxaban and dabigatran as alternatives to warfarin anticoagulation therapy.

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Section: Discussionmentioning

confidence: 99%

Anticoagulation therapy for thromboembolism prevention: a case of warfarin-induced skin necrosis in the setting of protein C deficiency

et al. 2017

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“…However, as they are excreted renally, especially dabigatran, their anticoagulation effects are affected by renal clearance. Their disadvantages also include a lack of a reversing antidote (as they are not dependent on the vitamin K pathway) and no standard test to measure its anticoagulation effect . Table summarizes the characteristics of these agents compared with warfarin.…”

Section: Summary Of the Survey Resultsmentioning

confidence: 99%

“…Their disadvantages also include a lack of a reversing antidote (as they are not dependent on the vitamin K pathway) and no standard test to measure its anticoagulation effect. 7 Table 2 summarizes the characteristics of these agents compared with warfarin. An understanding of the pharmacokinetics of these agents will help towards developing more specific guidance for skin surgery.…”

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confidence: 99%

Perioperative management of novel oral anticoagulants in skin surgery: a national survey

et al. 2016

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“…Anticoagulant therapy is a prerequisite to avoiding stroke and systemic embolism in patients with AF. The clinical use of oral anticoagulants began in 1954 after the approval of warfarin, which is a vitamin K antagonist (Plovanich and Mostaghimi, 2015). For more than half a century, warfarin was the only available oral anticoagulant (Bauer, 2013).…”

Section: Systematic Reviewmentioning

confidence: 99%

“…The DOACs have four important pharmacological properties: a rapid onset and offset of action, predictable therapeutic effect, fewer drug-drug interactions, and absence of food interactions (Bauer, 2013;Mekaj et al, 2015). These properties provide them with important advantages over traditional oral vitamin K antagonists such as warfarin (Plovanich and Mostaghimi, 2015). Since 2008, the European Medicine Agency (EMA) and the US Food and Drug Administration (FDA) have approved the clinical use of DOACs such as dabigatran, rivaroxaban, apixaban, and edoxaban in the European Union (EU) and worldwide (Mekaj et al, 2015).…”

Section: Systematic Reviewmentioning

confidence: 99%

Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

2017

British Journal of Pharmacy

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New oral anticoagulant agents continue to emerge on the market and their safety requires assessment to provide evidence of their suitability for clinical use. Therefore, we searched standard databases to summarize the English language literature on medicine-related problems (MRPs) of direct oral anticoagulants DOACs (dabigtran, rivaroxban, apixban, and edoxban) in the treatment of adults with atrial fibrillation. Electronic databases including Medline, Embase, International Pharmaceutical Abstract (IPA), Scopus, CINAHL, the Web of Science and Cochrane were searched from 2008 through 2016 for original articles. Studies published in English reporting MRPs of DOACs in adult patients with AF were included. Seventeen studies were identified using standardized protocols, and two reviewers serially abstracted data from each article. Most articles were inconclusive on major safety end points including major bleeding. Data on major safety end points were combined with efficacy. Most studies inconsistently reported adverse drug reactions and not adverse events or medication error, and no definitions were consistent across studies. Some harmful drug effects were not assessed in studies and may have been overlooked. Little evidence is provided on MRPs of DOACs in patients with AF and, therefore, further studies are needed to establish the safety of DOACs in real-life clinical practice.

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Novel oral anticoagulants: What dermatologists need to know

Cited by 27 publications

References 55 publications

Anticoagulation therapy for thromboembolism prevention: a case of warfarin-induced skin necrosis in the setting of protein C deficiency

Anticoagulation therapy for thromboembolism prevention: a case of warfarin-induced skin necrosis in the setting of protein C deficiency

Perioperative management of novel oral anticoagulants in skin surgery: a national survey

Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

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