Anticoagulants are prescribed to help prevent blood clots in those at risk of developing them, including people with artificial heart valves or atrial fibrillation, those who have had a heart attack or stroke and those at risk of deep vein thrombosis or pulmonary embolism. Warfarin is the most commonly prescribed anticoagulant but requires regular coagulation monitoring and has numerous interactions with other drugs and food. Four new oral anticoagulants (NOACs) are also available in the UK, which have a more predictable therapeutic response, a more rapid onset of action, fewer drug interactions and no requirement for regular coagulation monitoring. On this page you will find news stories and articles relating to anticoagulants, which cover the development and licensing of NOACs and the management of patients taking both NOACs and warfarin. Our research article also examines the impact of a pharmacist-led anticoagulant review clinic for high-risk patients.
Around 12,500 strokes are caused by atrial fibrillation (AF) in the UK each year, and 7,100 of these are preventable with appropriate anticoagulation. Four new oral anticoagulants (NOACs) are now available in the UK in addition to warfarin.
Risk stratification and ongoing care is important in non-ST elevation acute coronary syndrome, the new collective term for unstable angina and non-ST elevation myocardial infarction.
How to start patients on these common injected anticoagulants and optimise treatment.
CPD and research articles
Heparin is widely used for thromboprophylaxis or as a treatment in many clinical situations, however, it can cause serious adverse effects. Heparin-induced thrombocytopenia (HIT), an immune-mediated adverse drug reaction, is associated with high morbidity and mortality if undiagnosed.
How to identify causes of a subtherapeutic INRSubscription
Pharmacists and healthcare professionals are often involved in the management of patients with subtherapeutic international normalised ratios (INRs), the cause of which is important to identify because this will affect decisions and the subsequent management of the patient.
Local guidance, supported by the 2014 National Institute for Health and Care Excellence (NICE) guideline CG180 for atrial fibrillation (AF), recommends that patients receiving inadequate anticoagulation with a vitamin K antagonist (VKA), including time in therapeutic range (TTR) of <65%, should be reassessed. These patients were identified by the anticoagulation monitoring service (AMS) and highlighted to GPs for review. However, up to 59.3% of patients received ...
How antiphospholipid syndrome, also known as Hughes syndrome, is diagnosed and the appropriate therapeutic options for its management.
How patients on anticoagulants can be effectively managed in the perioperative period, including the evidence for the need for ‘bridging’ anticoagulation therapy and introduction of direct oral anticoagulants.
Thyroid dysfunction and drug interactionsSubscription
Correcting thyroid function can require dose adjustment of common medicines to prevent serious complications.
News and events
A new community pharmacy oral anticoagulant safety audit, developed by the NHS’s Specialist Pharmacy Service (SPS), has been endorsed by the Royal Pharmaceutical Society.
Researchers find that idarucizumab effectively counteracts the workings of anticoagulant dabigatran in emergency situations.
Clinical commissioning groups have been offloading responsibility for prescribing specialist drugs onto GPs, but many GPs say they have not been trained or paid to provide this service.
Results reinforce the importance of starting anticoagulation treatment as soon as possible after diagnosis, researchers conclude.
Study results show that choosing apixaban over warfarin could reduce the risk of anticoagulation-related intracranial haemorrhage.
Among patients with nonvalvular atrial fibrillation, study data show the use of dabigatran rather than warfarin was associated with a lower risk of osteoporotic fracture.
Genotype-guided dosing improves safety of warfarin Subscription
Older adults who received a genotype-guided dose of warfarin via a web application were less likely to experience adverse effects compared with clinical dosing, trial results show.
Atrial fibrillation patients not receiving guideline-recommended drugs to reduce stroke riskSubscription
Retrospective data analysis results show that the 16% of patients who were given anticoagulant prior to stroke showed reduction in stroke severity, lower odds of mortality and better functional outcomes.
Researchers find that blood clot rates in patients taking rivaroxaban were significantly lower than those taking aspirin, and there were no significant differences between bleeding side effects.
Patients prescribed antithrombotic drugs, such as low-dose aspirin, clopidogrel or warfarin, are at increased risk of having a subdural haematoma, research published in JAMA has confirmed.
Analysis of ‘real-life’ data comparing newer direct oral anticoagulants with warfarin has identified adverse drug reactions (ADRs) ‘not previously associated’ with the new treatments, including hip fracture.
Janssen may have withheld data from the US Food and Drug Administration about a faulty blood testing device used in a trial of the anticoagulation drug rivaroxaban, according to the results of an investigation by The BMJ.
Only a third of patients taking warfarin will retain stable blood levels in the long term, research published in JAMA has revealed (online, 9 August 2016).
The oral anticoagulant apixaban is consistently more effective than warfarin for patients with atrial fibrillation regardless of the number of other drugs they take, a study has found.
Many atrial fibrillation patients at risk of stroke treated with aspirin over anticoagulantsSubscription
Around 40% of atrial fibrillation patients who have an intermediate or high risk of stroke are treated only with aspirin, even though aspirin is less effective than oral anticoagulation, according to new research.
Large analysis of data shows taking aspirin within two weeks of transient ischaemic attack or stroke cuts risk of secondary stroke by over 90%.
Patients with atrial fibrillation (AF) being treated with warfarin have higher rates of dementia compared with those taking the drug for other conditions, research shows.
A study of 40,000 patients with atrial fibrillation suggests that warfarin is a valid treatment for stroke prevention.
The educational background of patients with atrial fibrillation directly influences how they manage their anticoagulation, according to research.
European regulator says anticoagulant is safe, despite question marks over its pivotal trialSubscription
The European Medicines Agency has reiterated the overall safety of rivaroxaban (Xarelto), an anticoagulant, despite a defect in a device used in a pivotal study behind the drug’s marketing approval in the European Union and the United States.
The validity of the data produced by a pivotal trial to gain approval for the direct oral anticoagulant, rivaroxaban (Xarelto), from the US and European regulators, has been called into question by an investigation.
New anti-platelet drug set for phase II study after success in patients with coronary heart disease.
Antidote to new oral anticoagulants proves effective Subscription
Anticoagulant effects of factor Xa inhibitors can be reversed by inactive recombinant factor Xa protein, andexanet, study shows.
The US medicines safety watchdog has given fast-track approval to idarucizumab (Praxbind), a drug that can neutralise the effects of the anticoagulant dabigatran etexilate (Pradaxa).
Idarucizumab (Praxbind), a unique drug that can neutralise the effect of anticoagulant dabigatran etexilate (Pradaxa), has been recommended for marketing authorisation by the European medicines safety watchdog.
Researchers introduced a new protocol in a cardiology unit to help ensure patients at risk were put on anticoagulants, but there were still high rates of under treatment.
More patients with atrial fibrillation are being protected against blood clots after the introduction of new direct oral anticoagulant drugs.
Researchers suggest indefinite anticoagulation for patients with unprovoked pulmonary embolismSubscription
Research into the benefits of warfarin for patients who have suffered a blockage in a lung artery suggest that the anticoagulant should be administered indefinitely.
People using oral blood thinning therapy such as warfarin can successfully monitor and manage their own international normalised ratio (INR) using commercially available devices, research shows.
Some patients who survive a heart attack fail to take the drugs they are prescribed after being discharged from hospital, a large US study has found.
The European Medicines Agency is recommending that edoxaban be made available for the prevention of stroke in atrial fibrillation and the prevention and treatment of venous thromboembolism.
Safeguarding patients against the risk of bleeding is a vital role for pharmacists when dealing with patients taking new oral anticoagulants.
Adherence to the oral anticoagulant dabigatran varies substantially among clinics and is higher at sites with pharmacist-led monitoring and appropriate patient selection, a US study has found.
Genetic analysis can point to patients who are at increased risk of suffering from bleeding during treatment with the blood thinner warfarin, a study published in The Lancet confirms.
A survey of nearly 70,000 patients taking aspirin for primary prevention has found that, for the overall cohort, treatment was inappropriate in nearly 11.6% of cases.