Apixaban in venous thromboembolism in an era of new oral anticoagulants

Several new oral anticoagulants (NOAC) have been recently studied and approved for the prevention and treatment of venous thromboembolism (VTE) which includes deep vein thrombosis and pulmonary embolism. Although, NOACs possess several advantages when compared to traditional therapy each has its own limitations; especially in the elderly and in patients with low body weight, renal impairment and in those with high risk of bleeding. Apixaban is a factor Xa inhibitor recently approved for the treatment and prevention of VTE in the United States. The purpose of this manuscript is to review describes the pharmacological properties of NAOC’s and to discuss clinical trial results and clinical applications of these agents in the prevention and treatment of VTE with special emphasis on the role of apixaban.