New anticoagulant agents: direct thrombin inhibitors
Review published in Cardiology Clinics (2008)
Abstract
Decades of research have been devoted to developing effective, safe, and convenient anticoagulant agents. In recent years, much emphasis has been placed on the development of direct thrombin inhibitors (DTIs) that offer benefits over agents like heparin and warfarin including the inhibition of both circulating and clot-bound thrombin; a more predictable anticoagulant response, because they do not bind to plasma proteins and are not neutralized by platelet factor 4; lack of required cofactors, such as antithrombin or heparin cofactor II; inhibiting thrombin-induced platelet aggregation; and absence of induction of immune-mediated thrombocytopenia. Various injectable DTIs are currently available and used for many indications. In addition, research is now focusing on oral DTIs that seem promising and offer various advantages, such as oral administration, predictable pharmacokinetics and pharmacodynamics, a broad therapeutic window, no routine monitoring, no significant drug interactions, and fixed-dose administration.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Cardiology-focused review of injectable DTIs (lepirudin, bivalirudin, argatroban) emphasizing their advantages over heparin and warfarin — clot-bound thrombin inhibition, no immune-mediated thrombocytopenia, no required cofactors.
Por qué esto importa para la hirudoterapia
Esta revisión examina los inhibidores directos de la trombina (IDT) como clase, enfatizando sus ventajas sobre la heparina y la warfarina —incluyendo la inhibición tanto de la trombina circulante como de la unida al coágulo, la farmacocinética predecible, la ausencia de requisitos de cofactores y la ausencia de trombocitopenia inmunomediada. El resumen menciona diversos IDT inyectables actualmente disponibles y la investigación en curso sobre IDT orales. No existe ninguna conexión defendible con sanguijuelas o la hirudoterapia en este resumen; no menciona hirudinas, sanguijuelas ni agentes derivados de sanguijuelas. La relevancia para el ámbito de la ASH es, por tanto, mínima o nula, ya que el artículo cubre los IDT como clase farmacológica general sin especificidad respecto a ningún compuesto relacionado con sanguijuelas.
Citación
New anticoagulant agents: direct thrombin inhibitors.
Nutescu EA et al. · Cardiology Clinics, 2008
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026