American Society of Hirudotherapy

Novel anticoagulants for the prevention and treatment of venous thromboembolism

Review published in Wiener medizinische Wochenschrift (1946) (2003)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentWeltermann A et al. · Wiener medizinische Wochenschrift (1946), 2003

Abstract

Unfractionated heparin, low molecular weight heparin and vitamin K antagonists are anticoagulants currently used for the prevention and treatment of deep vein thrombosis and pulmonary embolism. Considerable limitations of these agents, such as a narrow therapeutic window, a variable dose response or lack of oral bioavailability, created the need for new anticoagulants. Numerous new compounds with different mechanisms of action have been developed and some have been already approved for clinical use. Quite recently, fondaparinux, an indirect anti-factor Xa inhibitor, has been licensed in Europe and in the US for prevention of VTE in patients undergoing hip or knee replacement surgery. In addition, lepirudin, a recombinant hirudin derivative, and the heparinoid danaparoid, have been approved in Austria for treatment of heparin-induced thrombocytopenia. Recombinant nematode anticoagulant protein c2, the orally available thrombin inhibitor ximelagatran and ART-123, a recombinant soluble thrombomodulin, are in advanced stages of clinical development. This article reviews mechanisms and sites of action, and the current state of preclinical and clinical research of these and various other agents with respect to the prevention and treatment of venous thromboembolism).

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

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsAzetidinesBenzylaminesBlood Coagulation FactorsDrugs, InvestigationalFondaparinuxGlycineHeparinHeparin, Low-Molecular-WeightHumansPolysaccharidesPulmonary Embolism

Summary

Unfractionated heparin, low molecular weight heparin and vitamin K antagonists are anticoagulants currently used for the prevention and treatment of deep vein thrombosis and pulmonary embolism.

Why This Matters for Hirudotherapy

This review covers novel anticoagulants for prevention and treatment of venous thromboembolism, including fondaparinux, lepirudin, danaparoid, ximelagatran, recombinant nematode anticoagulant protein c2, and recombinant soluble thrombomodulin. The abstract states that lepirudin, described as a recombinant hirudin derivative, was approved in Austria for treatment of heparin-induced thrombocytopenia, and describes mechanisms and sites of action of these agents. For ASH's domain, there is relevance through the pharmaceutical hirudin derivative lepirudin, which is discussed as one among several novel anticoagulants. The caveat is that the review's scope is broad, no live hirudotherapy or native leech secretome is addressed, and the abstract does not describe hirudin's biological origin.

Citation

Novel anticoagulants for the prevention and treatment of venous thromboembolism

Weltermann A et al. · Wiener medizinische Wochenschrift (1946), 2003

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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