Anticoagulation is the mainstay of treatment for venous thromboembolism (VTE). For decades, patients and clinicians desiring an oral anticoagulant had only one choice - a vitamin K antagonist such as warfarin. Within the last year and a half, two new oral agents, dabigatran and rivaroxaban have been approved by the FDA for atrial fibrillation and thromboprophylaxis after orthopedic surgery. These novel anticoagulants along with several others in the pipeline, have demonstrated efficacy and safety in clinical trials of VTE and are likely to be approved for this indication in the near future.
With the availability of these new agents, patients and clinicians now have a choice among oral anticoagulants. Clinicians must be prepared to discuss the virtues and drawbacks of the various options with their patients, to optimize use of these agents in the treatment of VTE and to manage anticoagulant-related bleeding. Aimed at practicing hematologists, oncologists, hospitalists, general practitioners and other clinicians who manage venous thrombosis, the objective of this webinar was to provide clinicians with the information needed to meet these challenges.
Presentations and Speakers
Introduction to the New Oral Anticoagulants and Evidence of Their Efficacy and Safety
Speaker: David Garcia, MD, University of New Mexico
Dr. Garcia discussed the pharmacology of the new oral anticoagulants, with a focus on clinically pertinent characteristics that distinguish these agents from vitamin K antagonists. He also reviewed the results of phase III clinical trials in which new anticoagulant medicines have been studied for the treatment of venous thromboembolism.
Optimizing Therapy with Vitamin K Antagonists
Speaker: Sam Schulman, MD, McMaster University
Dr. Schulman reviewed evidence-based options to make treatment with vitamin K antagonists more effective, safer, and less inconvenient for patients on long-term anticoagulation. The presentation included the use of algorithms and computer software for decision support, self-testing, reduction of unnecessary dose changes and prolongation of recall intervals.
Management of the Bleeding Patient on Oral Anticoagulation
Speaker: Neil Zakai, MD, University of Vermont
With the advent of new oral anticoagulants, providers need to be aware of how to determine if bleeding is related to the oral anticoagulant and how to safely manage bleeding. In this webinar, Dr. Zakai presented an approach to the management of bleeding in patients on warfarin as well as the new oral anticoagulants.
Adam Cuker, MD, MS
University of Pennsylvania
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