NOAC, DOAC | 合法藥品大搜索

2016年9月19日—NOAC,DOAC,orTSOAC:WhatShouldWeCallNovelOralAnticoagulants?·History.Thefirstoralanticoagulant,warfarin,wasapprovedbythe ...

Since dabigatran’s introduction to the US market in 2010, the medical community hasn’t reached a clear consensus on the terminology for its drug class.

Initially, terms like “novel oral anticoagulant” (NOAC) were used extensively. But now, more than 6 years have passed and 3 additional NOACs have been approved by the FDA. The recognition that these drugs are no longer novel has led guidelines and international societies to reassess their nomenclature.

History

The first oral anticoagulant, warfarin, was approved by the FDA in 1954.1 For more than 60 years, warfarin was the only mainstream oral anticoagulant used in the United States.

Unlike all other anticoagulants, warfarin’s mechanism of action is quite unique. Instead of binding to active clotting factors to induce anticoagulation, it reduces the total amount of clotting factors in the circulation. Specifically, by inhibiting the C1 subunit o...