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The monitoring of warfarin and keeping the international normalized ratio (INR) between 2.0 and 3.0, along with avoiding over and under treatment, has driven a search for an alternative. [3] [14] A naturally occurring inhibitor of factor Xa was reported in 1971 by Spellman et al. from the dog hookworm. [15]
It is also used to treat atrial fibrillation to lower the risk of stroke caused by a blood clot. Another indication is a prophylactic treatment for blood clotting due to atherosclerosis. Rivaroxaban was the first FXa inhibitor on the market and then followed by apixaban, edoxaban and betrixaban.
Dabigatran is an oral direct thrombin inhibitor. Dabigatran (Pradaxa) was found to be noninferior to Warfarin in prevention of ischemic stroke, as well as intracranial hemorrhage risk and overall mortality for non-valvular atrial fibrillation according to the RE-LY trial. [9]
ELIQUIS ® (apixaban) Demonstrates Consistent Reductions in Stroke and Systemic Embolism, Major Bleeding and Mortality Compared to Warfarin in Patients with Nonvalvular Atrial Fibrillation at ...
The European Society of Cardiology (ESC), [21] and National Institute for Health and Care Excellence (NICE) [23] guidelines recommend that if the patient has a CHA 2 DS 2-VASc score of 2 and above, oral anticoagulation therapy (OAC) with a vitamin K antagonist (VKA, e.g. warfarin with target INR of 2-3) or one of the direct oral anticoagulant ...
U.S. FDA Approves ELIQUIS ® (apixaban) to Reduce the Risk of Stroke and Systemic Embolism in Patients with Nonvalvular Atrial Fibrillation ELIQUIS Demonstrated Superior Risk Reductions Versus ...
Subanalysis of Phase III ARISTOTLE Trial of Eliquis® (apixaban) Demonstrated Consistent Results Versus Warfarin in Patients with Nonvalvular Atrial Fibrillation with or without Valvular Heart ...
Compared to warfarin it has fewer interactions with other medications. [10] It is a direct factor Xa inhibitor. [6] In 2007, Pfizer and Bristol-Myers Squibb began the development of apixaban as an anticoagulant. [11] Apixaban was approved for medical use in the European Union in May 2011, and in the United States in December 2012.