Abstract
Thromboembolic disease is due to its incidence, morbidity and mortality a significant global medical and socioeconomic issue. Antithrombotic prevention and treatment represent one of the most important areas of interest in current medicine.
In the past, heparins, penta-carbohydrates and warfarin were primarily used in this area. However, despite its undisputed efficacy, warfarin is a problematic drug, mostly because of its inter-individual variability of effects, risks of drug interactions and interaction with various foodstuffs and its narrow “therapeutic window”.
The development of new, perorally efficient anticoagulants has focused primarily on direct thrombin inhibitors (dabigatran) and direct Xa factor inhibitors (rivaroxaban and apixaban). For prevention of cerebrovascular accidents in patients with non-valvular atrial fibrillation, dabigatran and rivaroxaban were first approved in our country, with rivaroxaban having the additional indication of the treatment of venous thromboembolic disease.
Edoxaban is perorally administered direct Xa factor inhibitor, which is currently being evaluated in phase III clinical studies aimed at both prevention of cerebrovascular accidents in patients with non-valvular atrial fibrillation and for prevention and treatment of venous thromboembolic accidents. These studies with edoxaban represent the largest singular clinical studies for these indications.