New Approaches in Anticoagulation Therapy

The search for an ideal anticoagulant is motivated by the well-known shortcomings of currently available anticoagulants. Current therapies, such as heparins and vitamin K antagonists (VKAs), have a number of clinically relevant limitations contributing to underuse by clinicians worldwide.^{57, 89, 131}
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New agents in development target specific points in the coagulation cascade, unlike current therapies, which affect the activity of multiple clotting factors.^{95, 131}

One of the main goals of this ongoing research is to develop a medication with as many properties of an ideal anticoagulant as possible, including^{89, 92}:

• Administered orally, one tablet once daily
• Highly effective in reducing venous thromboembolism
• Predictable dose response and kinetics
• Low rate of bleeding events
• No routine coagulation monitoring required
• Wide therapeutic window
• No dose adjustment required
• Little interaction with food or other drugs
• Low, non-specific plasma protein binding
• Inhibition of both free and clot-bound coagulation factors