Factor Xa inhibitors, Era to replace traditional anticoagulants

The past 15 years have seen increased usage of factor Xa inhibitor anticoagulants such as rivaroxaban, apixaban, and edoxaban, along with dabigatran (competitive direct thrombin inhibitor), which have been used increasingly in various clinical settings, for the prevention and treatment of thrombosis. In many ways Factor Xa inhibitors have replaced the use of warfarin, which requires prudent monitoring . Factor Xa inhibitor short half-lives, compared to warfarin’s, provide some assurance that the drug concentrations will decline rapidly when therapy is discontinued in patients with normal renal function. Good haemostatic efficacy was achieved in 83% patients on apixaban and 80% patients on rivaroxaban . Major bleeding events in nonvalvular atrial fibrillation patients on rivaroxaban were 3.6% per year and on apixaban were 2.13% per year in respective landmark trials conducted. Some drawbacks of Factor Xa inhibitors include uncertainty about dosing in some patient populations (eg, renal dysfunction, marked extremes of body weight), and their higher drug cost.