title: Treatment of venous thromboembolism and long-term prevention of recurrence: present treatment options and ximelagatran.
abstract: Despite the effectiveness of anticoagulant therapy for the treatment of acute venous thromboembolism and the prevention of recurrent venous thromboembolism, existing antithrombotic therapies are suboptimal. Unfractionated heparin, low-molecular-weight heparin (LMWH) and warfarin have practical limitations and carry the risk of treatment-related adverse events that restrict their clinical benefits and reduce cost-effectiveness. Efforts to achieve optimal venous thromboembolism prophylaxis by modifying the intensity of oral warfarin treatment have produced equivocal results, and there is a need for new, efficacious antithrombotic drugs providing predictable, well-tolerated oral dosing without the need for coagulation monitoring. Such agents would ideally have no significant food or drug interactions, and be suitable for both short- and long-term treatment. Ximelagatran, the first oral direct thrombin inhibitor, has the potential to fulfill many of the unmet needs in the management of venous thromboembolism.
authors.affiliation: Department of Medicine, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden. henryeriksson@swipnet.se
authors.forename: Henry
authors.initials: H
authors.lastname: Eriksson
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use*; D001596:Benzylamines; D002986:Clinical Trials as Topic; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D055502:Secondary Prevention; D013917:Thrombin / Q000037:antagonists & inhibitors*; D020246:Venous Thrombosis / Q000188:drug therapy / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D001384:Azetidines; D001596:Benzylamines; D006495:Heparin, Low-Molecular-Weight; C426686:ximelagatran; D014859:Warfarin; D013917:Thrombin