Fondaparinux: use in thromboprophylaxis of acute medical patients
Research article published in Drugs & aging (2008)
Abstract
Fondaparinux is a synthetic pentasaccharide that inhibits thrombin formation and thrombus development via selective antithrombin mediated inhibition of factor Xa. The complete bioavailability (100%) and elimination half-life of approximately 17 hours allows once-daily administration of fondaparinux. In a well designed trial (ARTEMIS) in acute medical patients aged > or = 60 years, fondaparinux was significantly more effective than placebo in terms of reducing the incidence of venous thromboembolism (VTE) up to day 15. The beneficial effect of fondaparinux therapy was observed in all subgroups of patients irrespective of underlying illness (e.g. acute heart failure or acute respiratory disease) in a predefined subgroup analysis of the ARTEMIS trial. Similarly, in a retrospective analysis of the trial, age and renal function did not appear to affect the incidence of VTE in fondaparinux and placebo recipients. Fondaparinux was generally well tolerated in this clinical trial. In patients receiving fondaparinux, the incidence of major bleeding was similar to that in patients receiving placebo and the incidence of minor bleeding was <3%.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Peer-reviewed research on anticoagulant and antithrombotic agents relevant to leech-derived compounds and thrombosis management. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This review describes fondaparinux, a synthetic pentasaccharide that blocks thrombin generation by antithrombin-mediated inhibition of factor Xa, and summarizes the ARTEMIS trial in which it reduced venous thromboembolism versus placebo in acutely ill medical patients aged 60 and over, with major bleeding similar to placebo. Its relevance to ASH is illustrative rather than direct: fondaparinux exemplifies the drug-discovery arc of turning a precisely targeted anticoagulant mechanism into a once-daily clinical agent, the same translational path proposed for leech-secretome molecules, and it sets a benchmark for the efficacy-versus-bleeding balance such candidates must meet. Caveat: this is a summary review centered on a single pivotal trial, fondaparinux is a chemically synthesized molecule unrelated to the medicinal leech, and nothing in the abstract concerns hirudotherapy; treat it as background on anticoagulant standards, not as leech-specific evidence.
Citation
Fondaparinux: use in thromboprophylaxis of acute medical patients.
Dhillon et al. · Drugs & aging, 2008
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