2. Pharmacokinetics and Drug Interaction of New Anticoagulants: Direct Thrombin Inhibitor and Factor Xa Inhibitors
Bibliographic record
Abstract
Vitamin K antagonists (VKA) such as warfarin are highly effective in preventing recurrent ischemic stroke of cardiac origin due to atrial fibrillation. During the last five decades, little progress has been made in the development of oral anticoagulants, and warfarin is the only oral anticoagulant currently recommended for the prevention of stroke in patients with moderate to high risk of stroke. Although effective, VKA have unpredictable pharmacologic effects, requiring regular coagulation monitoring and dose adjustment to maintain effects within the therapeutic range. These limitations increase the complexity of VKA use in the clinical setting, creating a burden for patients, physicians, and pharmacists. Therefore, the current focus of clinical development is on new oral anticoagulants that directly target thrombin or activated factor X(FXa). These new anticoagulants are more convenient than VKA, with predictable anticoagulant response, low potential of drug-drug interactions, and using fixed doses without coagulation monitoring. Recently, some of these drugs have been approved in the EU, Canada, and Japan for the prevention of thromboembolism in patients undergoing hip- and knee-replacement surgery, prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation, or prevention of cardiac events in patients with acute coronary syndromes. This review summarizes the pharmacokinetic properties and drug interactions of new anticoagulants (dabigatran etexilate, edoxaban, rivaroxaban, apixaban, idrabiotaparinux).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".