Old and new anticoagulant drugs: A minireview

Pier Mannuccio Mannucci, Massimo Franchini

Research output: Contribution to journalArticle

Abstract

The limits of traditional anticoagulants, such as heparin and warfarin, have prompted the search for new agents for prophylaxis and treatment of arterial and venous thromboembolism, including factor Xa and thrombin inhibitors. These agents can be given orally, and their most significant advantage is that no laboratory monitoring is needed. The anti-Xa inhibitor rivaroxaban and the direct thrombin inhibitor dabigatran etexilate are licensed for prophylaxis of venous thromboembolism (VTE) in high-risk orthopedic surgery. They are at least as safe and effective as heparins but much more expensive. Dabigatran, rivaroxaban, and other agents currently in the pipeline of clinical development have the potential to replace warfarin in the two most frequent indications for anticoagulation, i.e. secondary prophylaxis of VTE and atrial fibrillation. Prevention and treatment of coronary artery thrombosis in patients with ischemic heart disease is another area of investigation for the role of new anticoagulants. These drugs have the potential to meet some currently unmet needs of traditional anticoagulants, but available clinical data warrant confirmation and expansion. Lack of specific antidotes for anticoagulation reversal and the high cost are important limitations of their use.

Original languageEnglish
Pages (from-to)116-123
Number of pages8
JournalAnnals of Medicine
Volume43
Issue number2
DOIs
Publication statusPublished - Mar 2011

Fingerprint

Venous Thromboembolism
Anticoagulants
Warfarin
Heparin
Coronary Thrombosis
Antidotes
Antithrombins
Thrombin
Atrial Fibrillation
Orthopedics
Myocardial Ischemia
Coronary Vessels
Costs and Cost Analysis
Therapeutics
Pharmaceutical Preparations
Dabigatran
Rivaroxaban

Keywords

  • Cardiovascular disease
  • dabigatran
  • factor Xa inhibitors
  • fondaparinux
  • low-molecular-weight heparins
  • rivaroxaban
  • thrombin inhibitors
  • thromboembolism
  • unfractionated heparin
  • warfarin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Old and new anticoagulant drugs : A minireview. / Mannucci, Pier Mannuccio; Franchini, Massimo.

In: Annals of Medicine, Vol. 43, No. 2, 03.2011, p. 116-123.

Research output: Contribution to journalArticle

Mannucci, Pier Mannuccio ; Franchini, Massimo. / Old and new anticoagulant drugs : A minireview. In: Annals of Medicine. 2011 ; Vol. 43, No. 2. pp. 116-123.
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