[New anticoagulants].
This review updates the latest developments concerning new anticoagulants. It describes potential targets in the coagulation pathway: inhibition of the initiation of coagulation, factor Xa and thrombin inhibitors. The focus is laid on substances in late development that already passed the phase II trial for venous thromboembolism (VTE)-prevention as "proof of concept". In the group of factor Xa inhibitors, the indirect inhibitor Fondaparinux has got approval for the indications prevention and therapy of VTE and acute coronary syndromes (OASIS 5 and 6). Rivaroxaban is the first direct factor Xa inhibitor that was admitted for approval in the indication VTE-prevention. The first trial of the program RECORD 1-4 was finished, trials for the indications therapy of VTE (EINSTEIN) and stroke prevention in atrial fibrillation (ROCKET AF) are in phase III. The use in acute coronary symptoms is - like apixaban - evaluated in phase II. The ADOPT trial with apixaban for VTE-prevention, as well as the BOTTICELLI trial for atrial fibrillation, have reached phase III. After the withdrawal of Ximelagatran, Dabigatran is the most developed direct thrombin inhibitor, being extensively studied in the comprehensive phase- III-program REVOLUTION and in approval for the indication VTE-prevention.
Bauersachs
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RM
Medizinische Klinik IV - Max Ratschow Klinik für Angiologie, Klinikum Darmstadt, Heidelberger Landstr. 379, 64297 Darmstadt. Rupert.Bauersachs@Klinikum-Darmstadt.de
D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D004502:Education, Medical, Continuing; D015951:Factor Xa / Q000627:therapeutic use; D065427:Factor Xa Inhibitors; D000077425:Fondaparinux; D006801:Humans; D009025:Morpholines / Q000627:therapeutic use; D011134:Polysaccharides / Q000627:therapeutic use; D000069552:Rivaroxaban; D013876:Thiophenes / Q000627:therapeutic use; D016896:Treatment Outcome
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D009025:Morpholines; D011134:Polysaccharides; D013876:Thiophenes; D000069552:Rivaroxaban; D015951:Factor Xa; D000077425:Fondaparinux