New developments in parenteral anticoagulation for arterial and venous thromboembolism

The efficacy and safety of heparin and low-molecular-weight heparins (LMWHs) are well documented in venous and arterial thromboembolism. Several drawbacks of heparins have inspired the development of newer parenteral anticoagulants for specific indications, including heparin-induced thrombocytopenia (HIT) and percutaneous coronary interventions (PCI). The direct thrombin inhibitors recombinant hirudin and argatroban are now established alternatives for HIT patients, and bivalirudin is one of the most used anticoagulants in PCI. The pentasaccharide fondaparinux is an alternative for LMWH for thromboprophylaxis in various clinical settings and for patients with an acute coronary syndrome (ACS) not scheduled for PCI. In Europe, it was recently approved for treatment of superficial vein thrombosis. Further development of new parenteral anticoagulants is slow and the emphasis has shifted towards development of new oral anticoagulants and antiplatelet drugs. Still, promising new anticoagulants, some targeting less conventional targets in the coagulation system, have been developed and will undergo further clinical evaluation.

Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.

El resumen se deja sin traducir para conservar la redacción original de los autores.

Review of newer parenteral anticoagulants including recombinant hirudin, argatroban (HIT), bivalirudin (PCI), and fondaparinux (ACS, VTE prophylaxis, superficial vein thrombosis), noting a broader shift in emphasis toward new oral anticoagulants.

Explore cómo esta investigación se conecta con la práctica clínica

Más estudios revisados por pares en la categoría «Desarrollo de fármacos».

• Hirudoterapia en medicina y odontología — Jha K et al. (2015)
• Terapia con sanguijuelas: una historia — Hyson J (2005)
• Hirudinas de la sanguijuela medicinal asiática Hirudinaria manillensis: iguales, pero diferentes — Lukas P et al. (2019)
• Transcriptomic analysis of the salivary gland of medicinal leech Hirudo nipponia — Lu Z et al. (2018)
• Molecular dynamic and pharmacological studies on protein-engineered hirudin variants of Hirudinaria manillensis and Hirudo medicinalis — Sun Y et al. (2022)
• Síntesis acelular de la variante 1 de hirudina de la sanguijuela hematófaga Hirudo medicinalis — Wüstenhagen D et al. (2020)
• Producción de variantes de hirudina mediante fábricas microbianas modificadas genéticamente — Zhang J, Lan N (2018)
• Hirudina en la trombocitopenia inducida por heparina — Lubenow N, Greinacher A (2002)
• La hirudina mejora la nefropatía diabética al inhibir la piroptosis mediada por Gsdmd — Han J et al. (2023)
• La hirudina como anticoagulante alternativo: una revisión histórica — Markwardt F (2002)

Ver toda la investigación analizada por la ASH →