Current Drug Metabolism - Volume 18, Issue 7, 2017

Background: The Direct Oral Anticoagulants (DOACs) represent a new generation of antithrombotic agents, providing direct inhibition of either thrombin (factor IIa; FIIa) or activated factor X (FXa). Around the globe, their use is progressively rising, as these new agents replace the historical anticoagulants (heparin and vitamin K antagonists including warfarin) for various clinical conditions in medical practice. Other acronyms Read More

Background: Apixaban is an oral, potent, highly selective, reversible and direct inhibitor of activated coagulation factor X, that is the end point of the intrinsic and extrinsic coagulation pathway. Additionally, apixaban has the capacity to indirectly inhibit thrombin-induced platelet aggregation. This new oral anticoagulant represents an immediate-release form of peroral drug with quick dissolution, linear pharmacokinetics, good Read More

Background: The superiority of dabigatran has been well proven in the standard dosing regimen in prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) and extended venous thromboembolism (VTE) treatment. Dabigatran, an anticoagulant with a good safety profile, reduces intracranial bleeding in patients with atrial fibrillation and decreases major and clinically relevant non-major Read More

Background: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. Objective: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). Read More

Background: Direct oral anticoagulants (DOACs) offer consistent and predictable anticoagulation, oral administration with good patient compliance and a good safety profile. Dabigatran - a direct thrombin inhibitor, apixaban and rivaroxaban - direct factor Xa inhibitors are now largely used for anticoagulation in patients with nonvalvular atrial fibrillation and in patients with venous thromboembolism. These agents have emerged Read More

Background: The 10th edition of the CHEST Guideline and Expert Panel Report for the treatment of venous thromboembolism (VTE) was recently updated with recommendations on both the choice of anticoagulants and the duration of treatment in diverse clinical scenarios. Method: In this paper, we focus on news in the use of direct oral anticoagulants (DOACS), a group of synthetic low molecular weight drugs capable of di Read More

Background: Tumor recurrence is the most expected clinical event after the resection of non-muscle invasive bladder cancer, depending on histological findings of the initial lesion. In patients with low and intermediate risk of disease, the intravesical instillation of chemotherapy agents is recommended as a standard treatment to reduce recurrences. Methods: A comprehensive review covering various aspects of different Read More

Background: Inflammatory bowel diseases are chronic bowel disorders the causes of which have not been fully elucidated, though they all sharean immunological basis. They have an important impact on both quality of life of the patient and on healthcare services. Method: The incorporation of biological agents against tumour necrosis factor (TNF) alpha some 15 years ago represented a revolution in the management of patient Read More

Background: Vitamin D deficiency is one determinant of secondary hyperparathyroidism in the course of Chronic Kidney Disease (CKD). However, numerous studies support the notion that vitamin D may exert pleiotropic effects aside of mineral metabolism control. Indeed, vitamin D receptor has been identified in a great variety of tissues and its activation contributes to the parathyroid, intestine, cardiovascular and immune sy Read More