Robert Janknegt1*, Esther Metting2,Johan Kooistra3 and Richard Dekhuijzen4
1Hospital Pharmacist, Clinical Pharmacologist Sittard, The Netherlands
2Epidemiologist/Behavioral Scientist, University Medical Center, Groningen, The Netherlands
3BENU Pharmacies, Maarssen, The Netherlands
4Pulmonologist, Nijmegen, The Netherlands
*Corresponding Author: Robert Janknegt, Hospital Pharmacist, Clinical Pharmacologist Sittard, The Netherlands.
Received: October 19, 2020; Published: November 30, 2020
Objectives: The increasing number of direct acting anticoagulant drugs [DOACs] makes it almost impossible to have sufficient knowledge of each individual medicine and device, especially for general practitioners.
Reducing the number of medicines different DOACs, based on rational criteria, allows physicians
and pharmacists to build experience with a more limited set of medicines and to optimise patient information.
Methods: In this study DOACs are compared by means of the SOJA method.
The following selection criteria were applied: approved indications, available formulations, variability of the AUC, drug interactions, clinical efficacy, side effects, dosage frequency and documentation.
Results: Limited differences in scores were found between apixaban, dabigratran and rivaroxaban. Edoxaban showed a lower score, mostly because of its more limited clinical evidence and documentation. The ranking between the top 3 depends mostly on the assigned weight to the individual selection criteria.
Acquisition cost was not taken into account, because this varies with time. In practice acquisition cost is of course an important selection criterion, especially because there are very limited differences between the medicines from a clinical perspective. Exclusion of this criterion also makes this comparison more internationally applicable.
Conclusion: All DOACs are suitable for formulary inclusion, followed by a selection of the most suitable for a DOAC in individual patients, based on patient characteristics.
Keywords: Direct Acting Anticoagulant Drugs DOACs; Long Acting Beta Sympathocomimetics [LABA]; Long Acting Muscarine Antagonists [LAMA].
Citation: Robert Janknegt., et al. “Direct Oral Anticoagulants: Drug Selection by Means of the SOJA Method". Acta Scientific Pharmaceutical Sciences 4.12 (2020): 73-94.
Copyright: © 2020 Robert Janknegt., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.