New anticoagulants - promising and failed developments

New direct and indirect acting factor Xa (FXa) and thrombin inhibitors are being developed to overcome the downsides of the conventional anticoagulants - unfractionated and low molecular weight heparins and vitamin K antagonists. Ximelagatran and idraparinux failed to demonstrate an acceptable safet...

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Hauptverfasser: Harenberg, Job (VerfasserIn) , Hetjens, Svetlana (VerfasserIn) , Krejczy, Martin (VerfasserIn) , Wehling, Martin (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2012
In: British journal of pharmacology
Year: 2011, Jahrgang: 165, Heft: 2, Pages: 363-372
ISSN:1476-5381
DOI:10.1111/j.1476-5381.2011.01578.x
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1111/j.1476-5381.2011.01578.x
Verlag, Volltext: https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1476-5381.2011.01578.x
Volltext
Verfasserangaben:Job Harenberg, Svetlana Marx, Martin Krejczy and Martin Wehling

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520 |a New direct and indirect acting factor Xa (FXa) and thrombin inhibitors are being developed to overcome the downsides of the conventional anticoagulants - unfractionated and low molecular weight heparins and vitamin K antagonists. Ximelagatran and idraparinux failed to demonstrate an acceptable safety profile. Rivaroxaban and dabigatran are approved for the post-operative prevention of thromboembolic complications after elective hip or knee replacement surgery; dabigatran is approved for the prevention of embolism in patients with atrial fibrillation in an increasing number of countries. Several novel indirect antithrombin-dependent anticoagulants as well as antithrombin-independent oral direct FXa and thrombin inhibitors are investigated in multiple indications for the prophylaxis and treatment of venous thromboembolism and the prophylaxis of arterial thrombotic disorders. Quality-adjusted life years costs and incremental cost-effectiveness ratios are relatively high at present, but may decrease after approval of more new anticoagulants for additional indications. 
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