Recent advances in the treatment of venous thromboembolism

Abstract

Direct oral anticoagulants (DOAC)including edoxaban, apixaban or rivaroxaban were recently approved for the treatment of venous thromboembolism (VTE)in Japan. In treating of VTE, the risk-adjusted therapeutic strategies based on the early prognostic assessment are recommended. Thrombolytic therapy is generally accepted in pulmonary embolism as a shock in high-risk patients. Anticoagulant therapy is indicated for hemodynamically stable VTE. Initial anticoagulation can be selected from three methods;(1)conventional:where parenteral anticoagulant is administered for approximately a week overlapping with the initiation of warfari; (2)switching:where parenteral anticoagulant is switched to edoxaban;and(3)monotherapy:where an intensive dose of apixaban or rivaroxaban followed by a daily dose. Finally, the DOAC covering the demerits of the conventional method, provided an important advance, particularly concerning standardization and moderation of VTE management.