Updates on Use and Monitoring of Direct Thrombin Inhibitors

Direct thrombin inhibitors (DTIs) such as bivalirudin and argatroban have a predictable anticoagulant response, the ability to inhibit thrombin bound to fibrin, and efficacy in thrombotic environments. These properties make them a valuable tool to manage patients at risk of thrombotic events. DTIs require less frequent monitoring and dose adjustments than heparin. Due to poor correlation of activated partial thromboplastin time with DTI concentration, diluted thrombin time is widely used for monitoring bivalirudin anticoagulation. Emerging monitoring methods are promising and reflect the evolution of precision medicine toward more personalized, real-time monitoring techniques that can guide anticoagulation therapy in complex cases.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Up-to-date review of the clinical use and laboratory monitoring of direct thrombin inhibitors — including bivalirudin, argatroban, and dabigatran — which descended from leech hirudin, with attention to coagulation assay interpretation and dose adjustment.

Leech-derived molecules this paper discusses, each with a full profile in the ASH compound registry:

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