Inclusion in the world health organization model list of essential medicines of non-vitamin k anticoagulants for treatment of non-valvular atrial fibrillation: A step towards reducing the burden of cardiovascular morbidity and mortality

Ezequiel J. Zaidel*, Xinyi Leng, Abiodun Moshood Adeoye, Ferdous Hakim, Biraj Karmacharya, Asim Katbeh, Lis Neubeck, Stephanie Partridge, Pablo Perel, Mark D. Huffman, Mariachiara Di Cesare

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Non-vitamin K antagonist oral anticoagulants (NOACs) represent a paradigm shift in the treatment of non-valvular atrial fibrillation (AF) with major practice guidelines around the world recommending NOACs over vitamin K antagonist oral anticoagulants for initial treatment of AF for stroke prevention. Here we describe the evidence collated and the process followed for the successful inclusion of NOACs into the 21st WHO Model List of Essential Medicines (EML). Individual NOACs have been reported to be non-inferior or superior to warfarin in preventing stroke and systemic embolism in eligible AF patients with a reduction in the risk of stroke and systemic embolism and a lower risk of major bleeding in patients with non-valvular AF compared with warfarin in both RCTs and real-world data. The successful inclusion of NOACs in the WHO EML is an important step forward in the global fight against cardiovascular morbidity and mortality, especially in low- and middle-income countries, where the burden of disease is high and limited access to diagnosis and treatment translates into a higher burden of morbidity, mortality, and economic costs.

Original languageEnglish (US)
Article number52
JournalGlobal heart
Volume15
Issue number1
DOIs
StatePublished - Aug 2020

Keywords

  • Essential Medicine List
  • Non-valvular atrial fibrillation
  • Non-vitamin K antagonist oral anticoagulants (NOACs)
  • Prevention
  • Stroke

ASJC Scopus subject areas

  • Epidemiology
  • Community and Home Care
  • Cardiology and Cardiovascular Medicine

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