TY - JOUR
T1 - Managing venous thromboembolism in Asia
T2 - Winds of change in the era of new oral anticoagulants
AU - Cohen, Alexander
AU - Chiu, Kuan Ming
AU - Park, Kihyuk
AU - Jeyaindran, Sinnadurai
AU - Tambunan, Karmel L.
AU - Ward, Christopher
AU - Wong, Raymond
AU - Yoon, Sung Soo
N1 - Funding Information:
The Asia-Pacific Action on Venous Thromboembolism Treatment Advisory Board was supported by an educational grant from Bayer HealthCare Pharmaceuticals. Dr David Neil, UBM Medica Asia Pte. Ltd., provided writing assistance and editorial support, which was funded by Bayer HealthCare Pharmaceuticals.
PY - 2012/9
Y1 - 2012/9
N2 - Despite advances in the management of venous thromboembolism (VTE), treatment of many patients worldwide, especially in Asia, remains inadequate and/or discordant with prevailing guidelines. Although epidemiological studies consistently report lower incidences of VTE in Asians than Caucasians, VTE rates in Asia have probably been gravely underestimated, partly due to comparatively lesser ascertainment. It is becoming evident that Asians are at much higher risk of VTE than was hitherto supposed. Nevertheless, VTE risk-assessment is not routine in Asia and thromboprophylaxis rates are much lower than in Western nations. It is important to base decisions about anticoagulation on individual circumstances and weigh the potential benefits and risks. The conventional VTE management paradigm is not ideal. New oral anticoagulants offer advantages over current modalities that may help to streamline patient care and reduce healthcare costs. Initially, they will be mainly used in uncomplicated cases and, in the absence of clear differences in efficacy or safety, convenience, tolerability/adherence and cost will determine treatment choice. There is clear scope to improve VTE prevention and treatment in Asia. Key priorities are raising awareness of best practice and properly implementing guidelines. Uncertainty about the burden of VTE and concern about bleeding are barriers. High-quality Asian epidemiological data are needed to guide healthcare policy and evidence-based practice. More data on the occurrence and management of bleeding complications in Asian patients are also required. Meanwhile, physicians should remain vigilant and strive to act early, decisively and appropriately to diagnose and treat VTE, particularly in patients at high risk.
AB - Despite advances in the management of venous thromboembolism (VTE), treatment of many patients worldwide, especially in Asia, remains inadequate and/or discordant with prevailing guidelines. Although epidemiological studies consistently report lower incidences of VTE in Asians than Caucasians, VTE rates in Asia have probably been gravely underestimated, partly due to comparatively lesser ascertainment. It is becoming evident that Asians are at much higher risk of VTE than was hitherto supposed. Nevertheless, VTE risk-assessment is not routine in Asia and thromboprophylaxis rates are much lower than in Western nations. It is important to base decisions about anticoagulation on individual circumstances and weigh the potential benefits and risks. The conventional VTE management paradigm is not ideal. New oral anticoagulants offer advantages over current modalities that may help to streamline patient care and reduce healthcare costs. Initially, they will be mainly used in uncomplicated cases and, in the absence of clear differences in efficacy or safety, convenience, tolerability/adherence and cost will determine treatment choice. There is clear scope to improve VTE prevention and treatment in Asia. Key priorities are raising awareness of best practice and properly implementing guidelines. Uncertainty about the burden of VTE and concern about bleeding are barriers. High-quality Asian epidemiological data are needed to guide healthcare policy and evidence-based practice. More data on the occurrence and management of bleeding complications in Asian patients are also required. Meanwhile, physicians should remain vigilant and strive to act early, decisively and appropriately to diagnose and treat VTE, particularly in patients at high risk.
KW - Anticoagulant
KW - Asia
KW - Oral
KW - Treatment
KW - VTE
KW - Venous Thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=84865265185&partnerID=8YFLogxK
U2 - 10.1016/j.thromres.2012.05.025
DO - 10.1016/j.thromres.2012.05.025
M3 - Review article
C2 - 22766512
AN - SCOPUS:84865265185
VL - 130
SP - 291
EP - 301
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
IS - 3
ER -