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DOACs – advances and limitations in real world

Overview of attention for article published in Thrombosis Journal, October 2016
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Title
DOACs – advances and limitations in real world
Published in
Thrombosis Journal, October 2016
DOI 10.1186/s12959-016-0111-3
Pubmed ID
Authors

Lai Heng Lee

Abstract

The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials. Development of specific antidotes in management of bleeding complications and development of coagulation assays for their plasma levels will further boost the confidence in the DOACs. Nonetheless, there are still limitations associated with the DOACs. Many patients in need of anticoagulant therapy for indications not studied in the clinical trials will not be eligible for treatment with a DOAC. Conditions where more data is required include DOACs use in the paediatric age group, patients with atrial fibrillation and valvular heart disease, thrombosis associated with the anti-phospholipid syndrome and cancer associated thrombosis. The affordability and access to these drugs may pose an issue for many patients under healthcare systems not providing for these medications. With four new anticoagulants coming onboard very quickly, the focus has shifted to the practical approach and management in real life as many clinicians are not yet familiar with the DOACs. Clinicians need to be educated on how to manage this new class for drugs, from choosing the appropriate drug to prevention and managing bleeding complications as a lack of knowledge and understanding in these drugs will lead to inappropriate use and compromise on patient safety.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Slovenia 1 1%
Greece 1 1%
Unknown 83 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 24%
Unspecified 11 13%
Researcher 11 13%
Student > Postgraduate 9 11%
Other 9 11%
Other 25 29%
Readers by discipline Count As %
Medicine and Dentistry 36 42%
Unspecified 19 22%
Pharmacology, Toxicology and Pharmaceutical Science 18 21%
Agricultural and Biological Sciences 5 6%
Chemistry 3 4%
Other 4 5%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 December 2017.
All research outputs
#11,863,447
of 13,375,725 outputs
Outputs from Thrombosis Journal
#158
of 170 outputs
Outputs of similar age
#220,724
of 257,979 outputs
Outputs of similar age from Thrombosis Journal
#1
of 1 outputs
Altmetric has tracked 13,375,725 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 170 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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