Direct oral anticoagulant dose selection: Challenging cases

Direct oral anticoagulants (DOACs) are given in fixed doses without routine laboratory monitoring of their anticoagulant effect based on the results of pivotal phase III trials. In some of these trials, patients were randomly allocated to receive a higher or lower dose of a DOAC, whereas in others, most patients were given a standard dose and only a subset deemed to be at risk of drug accumulation was given a lower dose. Treatment guidelines …