View the Comparison Table: Some Oral Anticoagulants for VTE

Anticoagulants are the drugs of choice for treatment and prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE), collectively referred to as venous thromboembolism (VTE). US guidelines for treatment of VTE were updated in 2020 and 2021.

The direct oral anticoagulants (DOACs) apixaban (Eliquis) and rivaroxaban (Xarelto, and generics) are frequently used for treatment of acute venous thromboembolism (VTE) and are usually continued for at least 3 months. The other DOACs (edoxaban [Savaysa] and dabigatran [Pradaxa, and generics]) are alternatives for long-term treatment, but they require prior treatment with low-molecular-weight heparin for ≥5 days. Until recently, no large randomized trial directly comparing the safety of apixaban and rivaroxaban for treatment of VTE was available.

Atrial fibrillation (AF) is the most common arrhythmia in the world. Risk factor modification, anticoagulation, rhythm control, and rate control are the four pillars of its management. American College of Cardiology/American Heart Association (ACC/AHA) guidelines on management of AF were updated recently.

Balfaxar (Octapharma), a human plasma-derived four-factor prothrombin complex concentrate (PCC), has been approved by the FDA for rapid reversal of warfarin anticoagulation in adults who require an urgent surgical/invasive procedure. It is the second four-factor PCC to become available in the US; Kcentra, which has been available since 2013, is approved for the same indication and for urgent reversal of warfarin anticoagulation in adults with acute major bleeding. Balfaxar is marketed in Canada and Europe as Octaplex.