Thursday, 14 December 2017

NOACs and DOACs - a search strategy

Newer anticoagulant drugs, alternatives to warfarin, are a frequent talking point at Cardiology meetings, and I am making links with our Anticoagulation Service, which also needs to know about them.

These drugs are referred to as "novel (or new) oral anticoagulants" or NOACs, or "direct (or direct acting) oral anticoagulants", or DOACs.  They are, as I have heard pointed out, not so "new", now.

But how to find literature about them?   Some literature will of course use these phrases, but some will refer to specific drugs.    I have come up with:


MEDLINE

1.  doac* OR noac*).ti,ab 
2. DABIGATRAN/ OR "FACTOR XA INHIBITORS"/ OR ANTITHROMBINS/      
3. ((direct OR novel) ADJ2 "oral anticoagulant*").ti,ab
4.  “Direct thrombin inhibitor*”
5.  “factor xa inhibitor*” or “fxa inhibitor*”
6.  (dabigatran OR rivaroxaban OR apixaban OR edoxaban OR ximelagatran OR “fondaparinux sodium” OR bivalirudin OR argatroban OR angiox OR pradaxa OR xarelto OR eliquis OR Arixtra OR exembol).ti,ab             
7.  1 OR 2 OR 3 OR 4 OR 5 OR 6)     

EMBASE
1.  (doac* OR noac*).ti,ab 
2.  exp "BLOOD CLOTTING FACTOR 10A INHIBITOR"/ OR exp "THROMBIN INHIBITOR"/
3.  ((direct OR novel) ADJ2 "oral anticoagulant*").ti,ab
4.  “Direct thrombin inhibitor*”
5.  “factor xa inhibitor*” or “fxa inhibitor*”
6.  (dabigatran OR rivaroxaban OR apixaban OR edoxaban OR ximelagatran OR “fondaparinux sodium” OR bivalirudin OR argatroban OR angiox OR pradaxa OR xarelto OR eliquis OR Arixtra OR exembol).ti,ab             
7.  (1 OR 2 OR 3 OR 4 OR 5 OR 6)      

A PowerPoint from Imperial College Healthcare NHS Trust, called To DOAC or not to DOAC (Googling the title finds it!), provided three names (dabigatran, rivaroxaban, apixaban).  I added more names from the BNF.    Embase's indexing is extremely thorough, with a lot more individual drug names which I have not included in the free text search.

This post from Life in the Fast Lane explains some things about the names (as well as looking at the agents from a critical care perspective).

And this article from the Journal of Thrombosis and Haemostasis (subscription required) discusses recommendations for nomenclature.

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