title: [Clinical use of a new class of anticoagulant drugs: the direct thrombin inhibitors].
abstract: 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.
authors.affiliation: Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Policlinico Universitario Paolo Giaccone Via del Vespro, 14 90127 Palermo.
authors.forename: Danilo
authors.initials: D
authors.lastname: Puccio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Montalto
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Valerio
authors.forename: Angelo
authors.initials: A
authors.lastname: Ventimiglia
authors.forename: Alessandra
authors.initials: A
authors.lastname: Caronia
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
mesh_terms: 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
chemical_list: 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