Emerging anticoagulants for venous thromboembolism prevention
Review published in Am J Health Syst Pharm (2010)
Abstract
PURPOSE: To discuss the advantages and disadvantages of currently available anticoagulants, describe the characteristics of the ideal anticoagulant, and compare and contrast the mechanisms of action, pharmacokinetics, administration, efficacy, safety, and potential for drug interactions of currently available and emerging anticoagulants for prevention of venous thromboembolism (VTE). SUMMARY: Despite the proven efficacy of currently available agents for VTE prevention, several shortcomings exist that may prevent their use under various circumstances. These include administration by injection, narrow therapeutic index, unpredictable pharmacokinetics and pharmacodynamics, need for laboratory monitoring, risk for bleeding, and drug interactions. The ideal anticoagulant would overcome many of these issues; in particular, it would be available as an oral formulation. Dabigatran, an oral direct thrombin (factor IIa) inhibitor, and apixaban and rivaroxaban, oral direct factor Xa inhibitors, represent new agents for anticoagulation that may address many of these issues. While not available as an oral agent, desirudin is an additional option and offers increased flexibility when a non-heparin-based injectable anticoagulant is desired. Current literature indicates that these agents generally do not require laboratory monitoring and are safe and effective for VTE prevention in clinical studies of patients undergoing major orthopedic surgery. CONCLUSION: The development of new anticoagulants that may overcome limitations of existing agents represents an opportunity to further improve outcomes in patients at risk for VTE in orthopedic surgery.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
To discuss the advantages and disadvantages of currently available anticoagulants, describe the characteristics of the ideal anticoagulant, and compare and contrast the mechanisms of action, pharmacokinetics, administration, efficacy, safety, and potential for drug interactions of currently available and emerging...
Por qué esto importa para la hirudoterapia
Este artículo de revisión examinó los mecanismos de acción, la farmacocinética, la administración, la eficacia, la seguridad y el potencial de interacciones farmacológicas de los anticoagulantes disponibles actualmente y de los emergentes para la prevención del tromboembolismo venoso (TEV), incluyendo dabigatrán, apixabán, rivaroxabán y desirudina. Su relevancia para la ASH y la hirudoterapia es directa y bien fundamentada: la desirudina es hirudina recombinante derivada de la sanguijuela medicinal (Hirudo medicinalis), y el resumen la analiza como una opción inyectable no basada en heparina que ofrece mayor flexibilidad, con estudios clínicos que indican que estos agentes son generalmente seguros y eficaces sin monitorización analítica de rutina en pacientes sometidos a cirugía ortopédica mayor. Este artículo ayuda a situar un anticoagulante derivado del secretoma de la sanguijuela dentro del panorama más amplio de la farmacoterapia antitrombótica moderna. Una advertencia honesta es que se trata de una revisión narrativa centrada en la farmacoterapia convencional para la profilaxis quirúrgica del TEV; no aborda la terapia con sanguijuelas ni el secretoma de la sanguijuela en sentido amplio, más allá de la formulación farmacéutica de la desirudina.
Citación
Emerging anticoagulants for venous thromboembolism prevention.
Trujillo TC · Am J Health Syst Pharm, 2010
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026