Edoxaban (Savaysa): A Factor Xa Inhibitor.

INTRODUCTION Atrial fi brillation (AF), the most common cardiac arrhythmia, is encountered in clinical practice with ever-increasing frequency.1 Older data suggest that the lifetime risk of AF in men and women older than 40 years of age is approximately one in four.2 The prevalence of AF has most likely increased due to the aging of the “baby-boomers” (AF is overwhelmingly a disease of age) and improved overall survival. While AF in itself is not fatal, it increases patients’ risk of stroke or thromboembolism by up to fi vefold.3 Current treatment for AF is aimed at preventing its related complications—primarily stroke and thromboembolism.4 The primary prevention strategy for minimizing the risk of stroke in patients with AF is anticoagulation.5 Venous thromboembolism (VTE) is one of the three major causes of death associated with cardiovascular disease.6 VTE encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE); left untreated, VTE may manifest as either one.6 The U.S. Surgeon General has declared PE the most common preventable cause of death among hospitalized patients.6 For more than half a century, warfarin has remained the gold standard for anticoagulation. Since its approval for human medical use in 1954, warfarin continues to be the most widely prescribed oral anticoagulant in the U.S. for the treatment of AF, VTE, or both. A few years ago, new oral anticoagulants (NOACs) began entering DrUG FOrECAST