Evaluation of bleeding in patients receiving direct oral anticoagulants

Abstract

Erika L Hellenbart,1 Kathleen D Faulkenberg,2 Shannon W Finks3 1University of Illinois at Chicago College of Pharmacy, Chicago, IL, 2Cleveland Clinic, Cleveland, OH, 3University of Tennessee College of Pharmacy, Memphis, TN, USA Abstract: Direct oral anticoagulants (DOACs) are recognized by evidence-based treatment guidelines as the first-line option for the treatment of venous thromboembolism and prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. As use of these anticoagulants has become favored over the past several years, reported bleeding-related adverse drug events with these agents has increased. In randomized clinical trials, all DOACs have a reduced risk for intracranial hemorrhage, while major and other bleeding results have varied among the agents compared to vitamin K antagonists. We have reviewed the bleeding incidence and severity from randomized and real-world data in patients receiving DOACs in an effort to provide the clinician with a critical review of bleeding and offer practical considerations for avoiding adverse events with these anticoagulants. Keywords: bleeding, direct oral anticoagulants, dabigatran, rivaroxaban, apixaban, edoxaban, post-market bleeding

Keywords

• Bleeding
• Direct Oral Anticoagulants
• Dabigatran
• Rivaroxaban
• Apixaban
• Edoxaban