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Edoxaban: A Review in Deep Vein Thrombosis and Pulmonary Embolism

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Abstract

Edoxaban (Lixiana®, Savaysa®) is an oral, direct factor Xa inhibitor which has recently been approved for use in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) [collectively, venous thromboembolism (VTE)] and for the prevention of recurrent VTE. This article reviews the pharmacological properties of edoxaban as well as its tolerability and therapeutic efficacy in the treatment and prevention of recurrent VTE events. As demonstrated in the pivotal Hokusai-VTE phase III trial, once-daily edoxaban after initial treatment with heparin was non-inferior to standard therapy with heparin/warfarin in preventing recurrent VTE events and was associated with a significantly lower risk of clinically relevant bleeding than the traditional therapy. Edoxaban shares the advantages of other direct oral anticoagulants (DOACs) over traditional therapies, including the lack of requirement for routine coagulation monitoring, a rapid onset and offset of action, and few drug-drug interactions. It offers the convenience of once-daily dosing, can be taken without regard to food and allows for a dose reduction in patients with certain clinical features, such as moderate renal impairment or low body weight. In conclusion, edoxaban represents an effective and potentially safer alternative to traditional vitamin K antagonist therapy for the treatment and prevention of recurrent VTE. Its recent approval expands the range of DOAC agents for recurrent VTE, further facilitating treatment individualization.

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Acknowledgments

During the peer review process, the manufacturer of edoxaban was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Matt Shirley & Sohita Dhillon

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  1. Matt Shirley
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Correspondence to Matt Shirley.

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The preparation of this review was not supported by any external funding.

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Matt Shirley and Sohita Dhillon are salaried employees of Adis/Springer, are responsible for the content, and declare no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: T. L. Carman, Division of Cardiovascular Medicine, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; D. J. Quinlan, Department of Radiology, King’s College Hospital, London, UK.

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Shirley, M., Dhillon, S. Edoxaban: A Review in Deep Vein Thrombosis and Pulmonary Embolism. Drugs 75, 2025–2034 (2015). https://doi.org/10.1007/s40265-015-0495-6

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