[Clinical use of a new class of anticoagulant drugs: the direct thrombin inhibitors].
The coagulation cascade, and particularly thrombin, plays a very important role in arterial and venous thrombosis. Thereby, it is clear that thrombin inactivation is an optimal strategy for thrombotic disease prevention and treatment. The direct thrombin inhibitors are a new class of anticoagulant drugs directly binding thrombin and blocking its interaction with fibrinogen. The group of direct thrombin inhibitors includes recombinant hirudin (lepirudin and desirudin), bivalirudin, melagatran and its oral precursor, ximelagatran, argotraban and dabigatran. These drugs have several advantages compared to other anticoagulant drugs, and the particular pharmacokinetic properties of some of them could be very important for future management of thromboembolic prophylaxis. The efficacy and safety of these new drugs are evaluated in several clinical trials; however today only few clinical indications are available for the majority of them.
Puccio
Danilo
D
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Policlinico Universitario Paolo Giaccone Via del Vespro, 14 90127 Palermo.
Montalto
Salvatore
S
Valerio
Maria Carmela
MC
Ventimiglia
Angelo
A
Caronia
Alessandra
A
Novo
Salvatore
S
D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D000991:Antithrombins / Q000494:pharmacology / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use; D001596:Benzylamines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006629:Hirudins; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D013923:Thromboembolism / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome
D000925:Anticoagulants; D000991:Antithrombins; D001384:Azetidines; D001596:Benzylamines; D005343:Fibrinolytic Agents; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C109573:melagatran; C426686:ximelagatran; C074619:bivalirudin; C060225:desirudin; C083544:lepirudin