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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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DOACs – advances and limitations in real world
Published in
Thrombosis Journal, October 2016
DOI 10.1186/s12959-016-0111-3
Pubmed ID

Lai Heng Lee


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

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 102 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Greece 1 <1%
Denmark 1 <1%
Slovenia 1 <1%
Unknown 99 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 24 24%
Student > Postgraduate 12 12%
Researcher 12 12%
Other 11 11%
Student > Bachelor 9 9%
Other 21 21%
Unknown 13 13%
Readers by discipline Count As %
Medicine and Dentistry 43 42%
Pharmacology, Toxicology and Pharmaceutical Science 20 20%
Agricultural and Biological Sciences 5 5%
Chemistry 3 3%
Biochemistry, Genetics and Molecular Biology 3 3%
Other 5 5%
Unknown 23 23%

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.
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