Emerging strategies for treatment of venous thromboembolism.
Although considerable progress has been made in the treatment of venous thromboembolism (VTE), many unanswered questions remain, which are awaiting proper solution. Furthermore, new opportunities are emerging, which have the potential to rapidly change the therapeutic scenario. Selected patients with deep-vein thrombosis can be effectively and safely treated at home with fixed-dose low-molecular-weight heparins. The long-term use of low-molecular-weight heparins is likely to be more effective than and as safe as oral anticoagulants for the secondary prevention of VTE in cancer patients with venous thrombosis. Recent publications have unexpectedly raised a renewed interest on the use of thrombolytic drugs in patients with pulmonary embolism, at least in those who present with heart ventricular dysfunction. The optimal long-term treatment of VTE is still undefined. Finally, new categories of drugs are emerging, which have the potential to replace conventional anticoagulants in the near future. They include anti-Xa inhibitors, such as pentasaccharide, and antithrombin inhibitors, such as ximelagatran.
Prandoni
Paolo
P
University of Padua, Department of Medical and Surgical Sciences, 2nd Chair of Internal Medicine, Via Ospedale Civile 105, 35128, Padua, Italy. paoloprandoni@tin.it
D000925:Anticoagulants / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000639:trends; D015507:Drugs, Investigational / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D013923:Thromboembolism / Q000188:drug therapy* / Q000473:pathology; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000473:pathology
D000925:Anticoagulants; D015507:Drugs, Investigational; D005343:Fibrinolytic Agents