Treatment options for deep vein thrombosis.

IMPORTANCE OF THE FIELD: Anticoagulation is the main therapy for acute deep vein thrombosis (DVT) of the limbs. Over the last five decades, there has been little progress in the development of oral anticoagulant therapies. More recently, we have been experiencing a rapidly changing situation thanks to the development of new orally active anticoagulants.

AREAS COVERED IN THIS REVIEW: The aim of this review is to highlight main published data on direct thrombin and FXa inhibitors. The electronic database PubMed website and abstract proceedings were used to identify studies.

WHAT THE READER WILL GAIN: The main characteristics of these new classes of anticoagulant drugs, the development program of the most advanced molecules and the most recent published data on Phase III trials on DVT treatment for both the acute phase and the secondary prevention of the disease are reviewed.

TAKE HOME MESSAGE: Oral administration, predictable anticoagulant responses, low potential for drug-drug interactions and first published clinical data render direct thrombin and factor Xa inhibitors good candidates to replace oral vitamin K antagonist and low molecular weight heparins for DVT treatment.