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Abstract
Heparins and vitamin K antagonists (VKA) used commonly are the standard treatment
of venous and arterial thromboses. They are very efficient and safe, but have some
limitations: iatrogenicity, laboratory monitoring, parenteral use for heparins and
fondaparinux. Nowadays, four new inhibitors of factor Xa are used orally (rivaroxaban,
apixaban, edoxaban, betrixaban), and they are at least as efficient as heparins and
vitamin K antagonists. The objective is to substitute these indirect inhibitors of
factor Xa (heparins, low molecular weight heparins and fondaparinux) in the prevention
of venous and arterial thromboembolic episodes. The new direct inhibitors do not require
routine laboratory monitoring of blood coagulation. They inhibit the extrinsic and
the intrinsic pathways of blood coagulation. Rivaroxaban and apixaban are efficacious
and safe in the prevention of cerebral infarcts in patients with non-valvular fibrillation.
Apixaban is another direct inhibitor of factor Xa used orally which is developed in
the same indications as rivaroxaban. Edoxaban and betrixaban are also in development.
The objective of this work is to study the pharmacodynamic, pharmacokinetic, the efficacy
and safety of these four oral direct factor Xa inhibitors.