Treating deep vein thrombosis: novel ways to anticoagulate

A blog written by retired GP, Dr Lynda Ware, for clinicians.

The novel oral anticoagulants – or NOACs – are the new kids on the block in anticoagulation. They appear to be as effective as warfarin but with a better safety profile. A Cochrane review published in June 2015 (1) explores the role of NOACs in the treatment of deep vein thrombosis (DVT).

So what is novel about the NOACs?

DVTs  are conventionally treated with  parenteral  unfractionated heparin or subcutaneous low molecular weight heparin together with warfarin. Once therapeutic levels of warfarin have been reached, as measured by the International Normalised Ratio (INR),  heparin is discontinued. The NOACs comprise direct thrombin inhibitors (DTI) and direct Factor Xa Inhibitors  and were specifically designed to overcome the limitations of warfarin (2). They are given orally, have a predictable effect, do not require monitoring and dosing, and have few known drug interactions.

Click here to read Lynda's full blog on Evidently Cochrane.