Italian intersociety consensus on DOAC use in internal medicine.

Abstract:

:The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. This document represents a consensus paper on the use of DOACs by representatives of three Italian scientific societies: the Italian Society of Internal Medicine (SIMI), the Federation of the Associations of Hospital Managers (FADOI), and the Society for the Study of Haemostasis and Thrombosis (SISET). This document formulates expert opinion guidance for pragmatic managing, monitoring and reversing the anticoagulant effect of DOACs in both chronic and emergency settings. This practical guidance may help the internist to create adequate protocols for patients hospitalized ion internal medicine wards, where patients are often elderly subjects affected by poly-morbidities and renal insufficiency, and, thus, require particular attention to drug-drug interactions and peri-procedural protocols.

journal_name

Intern Emerg Med

authors

Prisco D,Ageno W,Becattini C,D'Angelo A,Davì G,De Cristofaro R,Dentali F,Di Minno G,Falanga A,Gussoni G,Masotti L,Palareti G,Pignatelli P,Santi RM,Santilli F,Silingardi M,Tufano A,Violi F,SIMI (Italian Society of Inte

doi

10.1007/s11739-017-1628-6

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

387-406

issue

3

eissn

1828-0447

issn

1970-9366

pii

10.1007/s11739-017-1628-6

journal_volume

12

pub_type

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