American Society of Hirudotherapy

[Clinical use of a new class of anticoagulant drugs: the direct thrombin inhibitors]

Review published in G Ital Cardiol (Rome) (2006)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentClinical TrialsPuccio D et al. · G Ital Cardiol (Rome), 2006

Abstract

The coagulation cascade, and particularly thrombin, plays a very important role in arterial and venous thrombosis. Thereby, it is clear that thrombin inactivation is an optimal strategy for thrombotic disease prevention and treatment. The direct thrombin inhibitors are a new class of anticoagulant drugs directly binding thrombin and blocking its interaction with fibrinogen. The group of direct thrombin inhibitors includes recombinant hirudin (lepirudin and desirudin), bivalirudin, melagatran and its oral precursor, ximelagatran, argotraban and dabigatran. These drugs have several advantages compared to other anticoagulant drugs, and the particular pharmacokinetic properties of some of them could be very important for future management of thromboembolic prophylaxis. The efficacy and safety of these new drugs are evaluated in several clinical trials; however today only few clinical indications are available for the majority of them.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsAntithrombinsAzetidinesBenzylaminesClinical Trials as TopicDrug Therapy, CombinationFibrinolytic AgentsHirudinsHumansPeptide FragmentsRecombinant ProteinsThromboembolism

Summary

The coagulation cascade, and particularly thrombin, plays a very important role in arterial and venous thrombosis.

Why This Matters for Hirudotherapy

This article discusses direct thrombin inhibitors (DTIs) as anticoagulants that bind thrombin and block its interaction with fibrinogen, listing recombinant hirudin (lepirudin and desirudin), bivalirudin, melagatran and ximelagatran, argatroban, and dabigatran as members of this drug class. It notes advantages over other anticoagulants and that efficacy and safety are under evaluation in clinical trials, with few clinical indications currently available. The abstract identifies lepirudin and desirudin as recombinant hirudins but makes no mention of leeches, the leech secretome, or hirudotherapy. The connection to ASH's domain is limited to the abstract's identification of certain drugs as recombinant hirudins within a broader discussion of pharmaceutical anticoagulants.

Citation

[Clinical use of a new class of anticoagulant drugs: the direct thrombin inhibitors].

Puccio D et al. · G Ital Cardiol (Rome), 2006

DOIPubMed

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