Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Br J Clin Pharmacol. 2021 Oct;87(10):3699-3705. doi: 10.1111/bcp.14796. Epub 2021 Mar 12.
Warfarin has existed for >7 decades and has been the anticoagulant of choice for many thromboembolic disorders. The recent introduction of direct-acting oral anticoagulants (DOACs) has, however, caused a shift in preference by healthcare professionals all over the world. DOACs have been found to be at least as effective as warfarin in prevention of stroke in patients with atrial fibrillation and in treatment of venous thromboembolism. In sub-Saharan Africa, however, the widespread use of DOACs has been hampered mainly by their higher acquisition costs. As the drugs come off patent, their use in sub-Saharan Africa is likely to increase. However, very few trials have been conducted in African settings, and safety concerns will need to be addressed with further study before widespread adoption into clinical practice.
华法林已经存在了超过 70 年，并且一直是许多血栓栓塞性疾病的首选抗凝药物。然而，最近直接作用的口服抗凝剂（DOACs）的引入已经导致全世界的医疗保健专业人员的偏好发生了转变。DOACs 已被发现至少与华法林一样有效，可以预防心房颤动患者的中风和治疗静脉血栓栓塞。然而，在撒哈拉以南非洲，DOACs 的广泛使用主要受到其更高的获取成本的阻碍。随着这些药物的专利到期，它们在撒哈拉以南非洲的使用可能会增加。然而，在非洲环境中进行的试验很少，在广泛应用于临床实践之前，还需要进一步研究来解决安全性问题。
