Hirudin, a new therapeutic tool?

Research article published in Annals of hematology (1991)

Última actualización: June 18, 2026Revisado por: ASH Editorial Board

Research article — evidence reviewArticle reference

Evidence: Observational studyDesarrollo de fármacosEnsayos clínicosBichler J, Fritz H · Annals of hematology, 1991

Abstract

Hirudin is the most potent natural inhibitor of thrombin known to date. It is gaining popularity as an anticoagulant now that recombinant and synthesized forms are available. It is a monospecific and co-factor-independent thrombin inhibitor with otherwise inert pharmacological properties. Being a surprisingly weak immunogen, its administration has exhibited no side effects, particularly on platelets. Bleeding complications are not to be expected at therapeutic doses. Effective anticoagulatory doses can be easily predicted and laboratory control is no problem. Application of hirudin or derivatives thereof may be indicated for: prophylaxis and treatment of postoperative venous thrombosis and diffuse microthrombosis; prevention of arterial thrombosis, especially in cardiac surgery; enhancement of fibrinolytic therapy and/or angioplasty to prevent reocclusion; extracorporeal circulation; and plastic surgery. Hirudin may be a particularly useful alternative anticoagulatory agent in patients sensitized to heparin or in patients with hereditary or acquired antithrombin III deficiency. However, whether hirudin is really an effective therapeutic tool and whether it can replace heparin in certain clinical indications can be judged only after extended clinical experience has been accumulated.

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

Publication typeComparative StudyJournal ArticleReview

Indexed MeSH termsAnimalsBlood CoagulationExtracorporeal CirculationHeparinHirudin TherapyHirudinsHumansThrombinThrombosis

Resumen

Hirudin is the most potent natural inhibitor of thrombin known to date. It is gaining popularity as an anticoagulant now that recombinant and synthesized forms are available.

Por qué esto importa para la hirudoterapia

Esta revisión examina la hirudin — descrita en el resumen como el inhibidor natural más potente de la trombina conocido — y sus propiedades farmacológicas, incluido su mecanismo monoespecífico e independiente de cofactores, su baja inmunogenicidad y la ausencia de efectos secundarios relacionados con las plaquetas, al tiempo que se esbozan posibles indicaciones como la profilaxis de la trombosis venosa, la cirugía cardíaca, la circulación extracorpórea y su uso como alternativa a la heparina en pacientes sensibilizados o con deficiencia de antitrombina III. El nombre del compuesto deriva del género de sanguijuelas Hirudo, lo que le confiere una conexión conceptual — aunque no explicitada en este resumen — con la hirudoterapia; sin embargo, la hirudin se aborda aquí únicamente como un agente farmacéutico recombinante o sintetizado, sin mención alguna de sanguijuelas, saliva de sanguijuela ni obtención a partir de sanguijuelas. La revisión no aporta datos experimentales ni clínicos nuevos, y los autores advierten explícitamente que si la hirudin puede realmente reemplazar a la heparina o servir como herramienta terapéutica efectiva solo podrá juzgarse tras una experiencia clínica prolongada.