Abstract
Warfarin, heparin and their derivatives have been the traditional anticoagulants used for prophylaxis and treatment of venous thromboembolism.
While the modern clinician is familiar with the efficacy and pharmacokinetics of these agents, their adverse effects have provided the impetus for the development of newer anticoagulants with improved safety, ease of administration, more predictable pharmacodynamics and comparable efficacy. Research into haemostasis and the coagulation cascade has made the development of these newer anticoagulants possible. These drugs include the factor Xa inhibitors and IIa (thrombin) inhibitors.
Direct and indirect factor Xa inhibitors are being developed with a relative rapid onset of action and stable pharmacokinetic profiles negating the need for close monitoring; this potentially makes them a more attractive option than heparin or warfarin. Examples of direct factor Xa inhibitors include apixaban, rivaroxaban, otamixaban, betrixaban and edoxaban. Examples of indirect factor Xa inhibitors include fondaparinux, idraparinux and idrabiotaparinux.
Direct thrombin inhibitors (factor IIa inhibitors) were developed with the limitations of standard heparin and warfarin in mind. Examples include recombinant hirudin (lepirudin), bivalirudin, ximelagatran, argatroban, and dabigatran etexilate.
This review will discuss emerging novel anticoagulants and their use for the prophylaxis and management of venous thromboembolism, for stroke prevention in nonvalvular atrial fibrillation and for coronary artery disease.
Keywords: Anticoagulants, heparin, warfarin, thrombin, traditional anticoagulants, prophylaxis, venous thromboembolism, pharmacokinetics, predictable pharmacodynamics, idrabiotaparinux
Current Medicinal Chemistry
Title:Emerging Anticoagulants
Volume: 19 Issue: 20
Author(s): B. Kennedy, F. S. Gargoum, L. Kennedy, F. Khan, D. R. Curran and T. M. O’Connor
Affiliation:
Keywords: Anticoagulants, heparin, warfarin, thrombin, traditional anticoagulants, prophylaxis, venous thromboembolism, pharmacokinetics, predictable pharmacodynamics, idrabiotaparinux
Abstract: Warfarin, heparin and their derivatives have been the traditional anticoagulants used for prophylaxis and treatment of venous thromboembolism.
While the modern clinician is familiar with the efficacy and pharmacokinetics of these agents, their adverse effects have provided the impetus for the development of newer anticoagulants with improved safety, ease of administration, more predictable pharmacodynamics and comparable efficacy. Research into haemostasis and the coagulation cascade has made the development of these newer anticoagulants possible. These drugs include the factor Xa inhibitors and IIa (thrombin) inhibitors.
Direct and indirect factor Xa inhibitors are being developed with a relative rapid onset of action and stable pharmacokinetic profiles negating the need for close monitoring; this potentially makes them a more attractive option than heparin or warfarin. Examples of direct factor Xa inhibitors include apixaban, rivaroxaban, otamixaban, betrixaban and edoxaban. Examples of indirect factor Xa inhibitors include fondaparinux, idraparinux and idrabiotaparinux.
Direct thrombin inhibitors (factor IIa inhibitors) were developed with the limitations of standard heparin and warfarin in mind. Examples include recombinant hirudin (lepirudin), bivalirudin, ximelagatran, argatroban, and dabigatran etexilate.
This review will discuss emerging novel anticoagulants and their use for the prophylaxis and management of venous thromboembolism, for stroke prevention in nonvalvular atrial fibrillation and for coronary artery disease.
Export Options
About this article
Cite this article as:
Kennedy B., S. Gargoum F., Kennedy L., Khan F., R. Curran D. and M. O’Connor T., Emerging Anticoagulants, Current Medicinal Chemistry 2012; 19 (20) . https://dx.doi.org/10.2174/092986712801215847
DOI https://dx.doi.org/10.2174/092986712801215847 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Molecular and Biochemical Changes of the Cardiovascular System due to Smoking Exposure
Current Pharmaceutical Design Targeting Complement in Rheumatoid Arthritis
Current Rheumatology Reviews ESVS Guidelines: Section A - Prevention in Patients with Carotid Stenosis
Current Vascular Pharmacology Effects of Perfluorocarbon Dodecafluoropentane (NVX-108) on Cerebral Microvasculature in the Healthy Rat
Current Drug Discovery Technologies Inflammation-Induced Thrombosis: Mechanisms, Disease Associations and Management
Current Pharmaceutical Design Coated with Nanomaterials Intraocular Lenses, Ophthalmic and Human Body Implantable Devices with High Catalytic Antioxidant Activities: A New Nanotechnology Strategy of Peroxidase Cellular Enzyme Mimics Increasing the Biocompatibility and Therapeutic Deployment of the Medical Prosthetic Device
Recent Patents on Drug Delivery & Formulation An Update on Herbal Anti-inflammatory Agents in Periodontal Therapy
Clinical Anti-Inflammatory & Anti-Allergy Drugs (Discontinued) The Role of the RhoA/rho-kinase Pathway in Pulmonary Hypertension
Current Drug Discovery Technologies The Roles of Mesenchymal Stem Cells in Tissue Repair and Disease Modification
Current Stem Cell Research & Therapy The Roles of β-Carotene in Cardiomyocytes
Current Nutrition & Food Science Acute Severe Arterial Hypertension: Therapeutic Options
Current Drug Targets Apoptosis: Potential Therapeutic Targets for New Drug Discovery
Current Medicinal Chemistry Biology and Therapeutic Applications of Peroxisome Proliferator- Activated Receptors
Current Topics in Medicinal Chemistry Towards More Efficient Glutathione Peroxidase Mimics: Substrate Recognition and Catalytic Group Assembly
Current Medicinal Chemistry Peptide5 Attenuates rtPA Related Brain Microvascular Endothelial Cells Reperfusion Injury via the Wnt/β-Catenin Signalling Pathway
Current Neurovascular Research Effects of Tea Catechins on Inflammation-Related Cardiovascular Diseases
Current Immunology Reviews (Discontinued) Non-Viral Gene Delivery Methods
Current Pharmaceutical Biotechnology Membrane Ion Channels and Diabetes
Current Pharmaceutical Design Ivabradine: a Selective If Current Inhibitor in the Treatment of Stable Angina
Recent Patents on Cardiovascular Drug Discovery The Angiotensin Converting Enzyme 2 (ACE2), Gut Microbiota, and Cardiovascular Health
Protein & Peptide Letters