The growing need for a safer, more efficient anticoagulant to replace older agents such as heparin and warfarin opened the door for many new agents that treat various coagulation disorders to emerge in the market. In 2015, the FDA gave the green light to a new fourth once-daily oral agent, direct factor Xa inhibitor called: Edoxaban (Savaysa). It is currently approved for the treatment of venous thromoboembolism (VTE) and nonvalvular atrial fibrillation. A randomized double- blinded control trial showed Edoxaban to be non inferior than warfarin in preventing recurrent symptomatic VTE. Another double-blinded RCT showed Edoxaban to have a significantly lower annual rates of major bleeding, intracranial bleeding, and cardiovascular death compared to warfarin in patients with atrial fibrillation, stroke, or systemic embolism, yet these rates were higher in patients with deteriorated renal function. Edoxaban’s high renal clearance, the fact that it is not dialyzable and the lack of specific reversal agents are some of the concerns that accompanied its approval. Where do you see this agent among the newer anticoagulants?  

For additional information please read JAMA

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