Emerging anticoagulants
Review published in Current Medicinal Chemistry (2012)
Abstract
Warfarin, heparin and their derivatives have been the traditional anticoagulants used for prophylaxis and treatment of venous thromboembolism. While the modern clinician is familiar with the efficacy and pharmacokinetics of these agents, their adverse effects have provided the impetus for the development of newer anticoagulants with improved safety, ease of administration, more predictable pharmacodynamics and comparable efficacy. Research into haemostasis and the coagulation cascade has made the development of these newer anticoagulants possible. These drugs include the factor Xa inhibitors and IIa (thrombin) inhibitors. Direct and indirect factor Xa inhibitors are being developed with a relative rapid onset of action and stable pharmacokinetic profiles negating the need for close monitoring; this potentially makes them a more attractive option than heparin or warfarin. Examples of direct factor Xa inhibitors include apixaban, rivaroxaban, otamixaban, betrixaban and edoxaban. Examples of indirect factor Xa inhibitors include fondaparinux, idraparinux and idrabiotaparinux. Direct thrombin inhibitors (factor IIa inhibitors) were developed with the limitations of standard heparin and warfarin in mind. Examples include recombinant hirudin (lepirudin), bivalirudin, ximelagatran, argatroban, and dabigatran etexilate. This review will discuss emerging novel anticoagulants and their use for the prophylaxis and management of venous thromboembolism, for stroke prevention in nonvalvular atrial fibrillation and for coronary artery disease.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Comprehensive review of emerging anticoagulants including hirudin-class direct thrombin inhibitors (recombinant hirudin, lepirudin, bivalirudin, argatroban, ximelagatran, dabigatran) and direct factor Xa inhibitors for VTE, AF, and coronary disease.
Por qué esto importa para la hirudoterapia
Este artículo de revisión examina los anticoagulantes emergentes para la profilaxis y el tratamiento del tromboembolismo venoso, la prevención del ictus en la fibrilación auricular no valvular y la enfermedad arterial coronaria, abarcando tanto los inhibidores del factor Xa (p. ej., apixabán, rivaroxabán, otamixabán, betrixabán, edoxabán) como los inhibidores directos de la trombina (p. ej., hirudina recombinante/lepirudina, bivalirudina, argatrobán, dabigatrán etexilato). La hirudina recombinante se menciona solo como un ejemplo dentro de la clase más amplia de inhibidores directos de la trombina, señalado por surgir de los esfuerzos por superar las limitaciones de la heparina y la warfarina. La relevancia para la ASH es indirecta y contextual, al situar a la hirudina dentro de la farmacopea anticoagulante. No se aportan datos originales, dosificaciones específicas ni discusión específica sobre hirudoterapia; los lectores que busquen orientación clínica o práctica sobre hirudoterapia encontrarán aquí solo información general de fondo.
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026