Desirudin: a review of its use in the management of thrombotic disorders
Review published in Drugs (2000)
Abstract
UNLABELLED: Desirudin, a recombinant hirudin used in the prevention and management of thromboembolic disease, is a thrombin inhibitor which binds directly and with high affinity to clot-bound and fluid phase thrombin. As a prophylaxis in patients undergoing hip replacement surgery, desirudin was significantly more effective in reducing the incidence of deep vein thrombosis (DVT) than either unfractionated or low molecular weight heparin. However, results in patients with acute coronary syndromes are less conclusive. A significant reduction with desirudin compared with heparin in the incidence of death or non-fatal (re)infarction at 24 hours in patients with acute myocardial infarction (MI) was reported in the GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) IIb trial but not in the TIMI (Thrombolysis and Thrombin Inhibition in Myocardial Infarction) 9B trial. Despite the early reduction shown in GUSTO IIb, desirudin was not associated with an improved long term clinical benefit at 30 days compared with heparin. Similar results were seen in patients with unstable angina/non-Q-wave MI enrolled in the GUSTO IIb trial. In addition, desirudin and heparin showed similar efficacy in preventing restenosis 30 weeks after coronary angioplasty for unstable angina, despite desirudin being associated with a significant reduction in the rate of cardiac events within the first 96 hours. Desirudin is as well tolerated as heparin with a similar incidence of moderate and severe bleeding, intracranial haemorrhage or stroke reported when trialled in the prevention of DVT associated with hip replacement surgery or the treatment of acute coronary syndromes. However, in the GUSTO IIb trial a significantly higher incidence of transfusions was observed in patients with unstable angina/non-Q-wave MI. CONCLUSIONS: Desirudin is clearly more effective than heparin in the prevention of DVT in patients undergoing elective hip replacement, although cost factors may influence its ultimate place in therapy. In the treatment of acute coronary syndromes the role of desirudin is less certain; however, it may be useful for patients in whom heparin therapy is not a viable option.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Desirudin: a review of its use in the management of thrombotic disorders.
Por qué esto importa para la hirudoterapia
This article evaluates the clinical use of desirudin, identified in the abstract as a recombinant hirudin and thrombin inhibitor, in the management of thromboembolic diseases including deep vein thrombosis prophylaxis and acute coronary syndromes. The abstract reports that desirudin was significantly more effective than unfractionated and low-molecular-weight heparin in reducing DVT incidence after hip replacement, while results in acute coronary syndromes were less conclusive with no sustained long-term clinical benefit at 30 days. Desirudin showed similar tolerability to heparin overall, though higher transfusion rates were observed in one trial. The abstract does not mention leeches, leech saliva, or hirudotherapy, so the connection to ASH's domain is limited to the pharmaceutical term 'recombinant hirudin' without further elaboration.
Citación
Desirudin: a review of its use in the management of thrombotic disorders
Matheson AJ et al. · Drugs, 2000
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026