Direct thrombin inhibitors
- 9 September 2011
- journal article
- review article
- Published by Wiley in British Journal of Clinical Pharmacology
- Vol. 72 (4), 581-592
- https://doi.org/10.1111/j.1365-2125.2011.03916.x
Abstract
Heparins and vitamin K antagonists have been the primary agents used for anticoagulation in certain cardiovascular and thromboembolic diseases for over 50 years. However, they can be difficult to administer and are fraught with limitations. In response to the need for new anticoagulants, direct thrombin inhibitors (DTIs) have been developed and investigated for their utility in prophylaxis and treatment of venous thromboembolism (VTE), heparin-induced thrombocytopenia (HIT), acute coronary syndromes (ACS), secondary prevention of coronary events after ACS, and nonvalvular atrial fibrillation. Currently, four parenteral direct inhibitors of thrombin activity are FDA-approved in North America: lepirudin, desirudin, bivalirudin and argatroban. Of the new oral DTIs, dabigatran etexilate is the most studied and promising of these agents. This review discusses the clinical indications and efficacy of these direct thrombin inhibitors as well as future directions in anticoagulant therapy.Keywords
This publication has 62 references indexed in Scilit:
- Newly Identified Events in the RE-LY TrialThe New England Journal of Medicine, 2010
- Desirudin Dosing and Monitoring in Moderate Renal ImpairmentThe Journal of Clinical Pharmacology, 2010
- Rationale and design of the PREVENT-HIT study: A randomized, open-label pilot study to compare desirudin and argatroban in patients with suspected heparin-induced thrombocytopenia with or without thrombosisClinical Therapeutics, 2010
- Coadministration of Dabigatran Etexilate and AtorvastatinAmerican Journal of Cardiovascular Drugs, 2009
- Pharmacokinetics and Pharmacodynamics of the Direct Oral Thrombin Inhibitor Dabigatran in Healthy Elderly SubjectsClinical Pharmacokinetics, 2008
- Clinical Pharmacokinetics and Pharmacodynamics of the Oral Direct Thrombin??Inhibitor Dabigatran EtexilateClinical Pharmacokinetics, 2008
- The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjectsBritish Journal of Clinical Pharmacology, 2007
- New anticoagulantsBlood, 2005
- Rationales Design von Thrombinhemmstoffen: Von Fibrinogen und Hirudin zu synthetischen AntikoagulanzienPharmazie in unserer Zeit, 2004
- The Structure of a Complex of Recombinant Hirudin and Human α-ThrombinScience, 1990