The year 2017 was particularly rich in new developments in the field pertaining to coagulation disorders, be they thrombotic or hemorrhagic. Several studies further confirmed the role of direct oral anticoagulants (DOACs) at reduced dose levels for the secondary prevention of venous thromboembolic disease. These same agents will likely replace low molecular weight heparins (LMWHs) in cancer patients with antecedents of venous thromboembolism. A specific and extensively validated antidote is already available for dabigatran (idarucizumab). While awaiting the validation of specific antidotes for factor Xa anticoagulants, prothrombin complex concentrates (PCCs) have been shown to be effective, even at reduced dose levels, in patients requiring rapid reversibility of anticoagulation induced by an anti-Xa agent. In the hemophilia setting, the development of a bispecific antibody mimicking the action of FVIII (emicizumab), along with the first successes of gene therapy for hemophilia A open revolutionary perspectives as to the management of this rare disease.
Key words
New oral anticoagulants, antidotes, cancer, haemophilia, gene therapy