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Low-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation

Ki Hong Lee|Hyung Wook Park
대한내과학회 (The Korean Association Of Internal Medicine)|2023.09|The Korean Journal of Internal Medicine|제38권 제5호|pp. 583-594

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참고문헌

키워드

Atrial fibrillationOff-label useAnticoagulant agents
주제분류내과학

초록

In the last decade, non-vitamin K antagonist oral anticoagulants (NOACs), a new generation of OACs, were introduced to prevent thromboembolism in patients with atrial fibrillation. Although vitamin K-dependent anticoagulants have long been used as OACs, their inherent disadvantage of considerable bleeding complications has limited their use. NOACs demonstrate similar or superior clinical outcomes to those of warfarin. Although strict dose reduction criteria are recommended for NOACs, low-dose NOACs are frequently utilized, especially in Asian patients. Low-dose NOACs have shown clinical outcomes similar to those of warfarin in randomized controlled trials (RCTs) and real-world studies. However, off-label low-dose NOACs have shown inconsistent results compared with standard-dose NOACs and warfarin. Therefore, strict dose reduction criteria for NOACs should be followed until RCTs confirm the issues associated with NOAC underdosing.

Abstract

In the last decade, non-vitamin K antagonist oral anticoagulants (NOACs), a new generation of OACs, were introduced to prevent thromboembolism in patients with atrial fibrillation. Although vitamin K-dependent anticoagulants have long been used as OACs, their inherent disadvantage of considerable bleeding complications has limited their use. NOACs demonstrate similar or superior clinical outcomes to those of warfarin. Although strict dose reduction criteria are recommended for NOACs, low-dose NOACs are frequently utilized, especially in Asian patients. Low-dose NOACs have shown clinical outcomes similar to those of warfarin in randomized controlled trials (RCTs) and real-world studies. However, off-label low-dose NOACs have shown inconsistent results compared with standard-dose NOACs and warfarin. Therefore, strict dose reduction criteria for NOACs should be followed until RCTs confirm the issues associated with NOAC underdosing.

참고문헌 (48)

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Asian Patients with Stroke plus Atrial Fibrillation and the Dose of Non-Vitamin K Oral Anticoagulants허지회, Keun-Sik Hong, Oh Young Bang대한뇌졸중학회 · 대한뇌졸중영문학회지2016 · 제18권 제2호Label Adherence for Non-Vitamin K Antagonist Oral Anticoagulants in a Prospective Cohort of Asian Patients with Atrial Fibrillation김준, 강기운, 김진배, 김창수, 김태훈, 박준범, 박지숙, 박진규, 박형욱, 심재민, 엄재선, 이소령, 이영수, 이정명, 정보영, 차명진, 최의근연세대학교의과대학 · Yonsei Medical Journal2019 · 제60권 제3호Apixaban을 투여받는 비판막성 심방세동 환자에서 투여 용량에 따른 유효성 및 안전성 평가권은영, 김유경, 안서현, 윤정이, 황보신이한국병원약사회 · 병원약사회지2020 · 제37권 제2호Comparative efficacy and safety of warfarin and direct oral anticoagulants in patients with end-stage kidney disease and atrial fibrillationJae-Hyeong Park, Ji Hoon Jung, Sun Hwa Lee, Wonmook Hwang, Yujin Yang대한내과학회 · The Korean Journal of Internal Medicine2026 · 제41권 제1호비판막성심방세동 환자에서 직접작용 경구용 항응고제 임상적 효과와 부작용 연구이숙향, 정민지, 홍지원한국임상약학회 · 한국임상약학회지2022 · 제32권 제1호새로운 항응고제의 임상적 적용: 비판막성 심방세동 환자에서 뇌졸중의 예방을 위한 새로운 항응고제의 사용을 중심으로김동민, 이명용대한내과학회 · 대한내과학회지2014 · 제87권 제1호

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