University of Leeds, UK
Title: NOACS-Novel oral anticoagulants: Are we there yet?
Helen Philippou completed her PhD in 1997, from the University of London (Charing Cross and Westminster Medical School), UK and immediately obtained a tenured post at Imperial College, London, UK followed by the University of Leeds, UK, where she is an Associate Professor. She is Academic Theme Lead of Translational Cardiovascular Research, at the University of Leeds. She is also the current Chairman of the FXIII and Fibrinogen Subcommittee of the International Society of Thrombosis and Haemostasis.
Thrombosis results in 25,000 and 200,000 fatalities from venous and arterial thrombosis, respectively, annually in the UK alone. Hitherto, anticoagulants are used to prevent stroke in patients with atrial fibrillation (AF), and to prevent deep venous thrombosis and pulmonary embolism in medical or surgical patients. However current anticoagulant treatments are associated with a significant risk of bleeding. There is an urgent clinical need for safe, effective anticoagulant therapies which prevent thrombotic events without causing the significant bleeding side-effects of currently available treatments. Warfarin has for some time been the standard anticoagulant treatment approved for widespread clinical use but is associated with many problems including a significant risk of bleeding and the need for careful laboratory monitoring regularly to achieve dosing of the drug within the therapeutic dose range. New oral agents have recently been approved for long term use (a direct thrombin inhibitor, dabigatran, and activated factor X (FXa) inhibitors, rivaroxaban and apixaban). These newer drugs address some of the clinical shortcomings of warfarin, most important of which is that the requirement to monitor and adjust the treatment dose is obviated. However, significant major and minor bleeding risks remain associated with these new agents. This work will discuss the attributes of an “ideal” anticoagulant and where we need to focus our attention if we are to address the major unmet clinical need of current anticoagulation therapy.