Advances in antithrombotic treatment – antithrombotics with anti‑Xa effect

Česká verzia

Authors: A. Bátorová
Authors place of work: Národné hemofilické centrum, Klinika hematológie a transfuziológie Lekárskej fakulty UK a FN Bratislava, Slovenská republika, prednosta doc. MUDr. Martin Mistrík, Ph. D.
Published in the journal: Vnitř Lék 2009; 55(3): 295-301
Category: 15th Parizek's Days

Summary

The use of anticoagulants in the prophylaxis and treatment of arterial and venous thrombosis has substantially expanded during the last years. Increasing knowledge about the inherited and acquired thrombophilia and the risk factors predisposing to the recurrency of thromboembolic events result in a new indications for primary and secondary thromboprophylaxis with prolonged or even life-long duration. The limitations of classical anticoagulans, heparin and vitamin K antagonists support the development of medicaments with a specific antithrombotic action. The new generation anticoagulants inhibit in a specific way either particular coagulation enzyme or hemostasis activation step. Based on the in vitro studies and extensive clinical observations the activated factor Xa (F Xa) seems to be one of the most advantageous targets for a specific action of perspective antithrombotic agents. Two selective F Xa inhibitors have been approved for clinical use: fondaparinux is an indirect parenteral F Xa inhibitor, and most recently approved rivaroxaban is the first oral anti‑Xa inhibitor. Other anti‑Xa molecules are under development for either parenteral (idraparinux, DX-9065a) or oral use (razaxaban, apixaban, rivaroxaban, LY-51, 7717, BMS-56247 a DU-176b).

Key words:
new anticoagulants – factor Xa – selective anti‑factor Xa inhibitors

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