Key result
Direct thrombin inhibitors and Factor X inhibitors are the most clinically advanced among the novel anticoagulants targeting specific steps in the coagulation cascade.
This review highlights the development of novel anticoagulants targeting specific coagulation cascade steps, with direct thrombin and Factor X inhibitors being the most clinically advanced.
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May guide anticoagulant development priorities; leaves open comparative RCT data before clinical adoption.
Well-documented drawbacks of traditional anticoagulants have lead to the quest for an ideal anticoagulant resulting in a surge of novel anticoagulant molecules. These newer agents directly target specific steps in coagulation cascade and include newer low molecular weight heparins (adomiparin), ultra low molecular weight heparins (semuloparin, RO-14), inhibitors of activated factor II (dabigatran, AZD0837), X (rivaroxaban, apixaban, edoxaban, betrixaban), IX (REG1,2), XI (antisense oligonucleotides, BMS 262084, clavatadine A), VII/tissue factor (tifacogin, PCI 274836, and BMS 593214), V (recomodulin, solulin), VIII (TB402), dual thrombin/factor X inhibitors (EP21709, tanogitran), and newer vitamin K antagonists (tecarfarin). Direct thrombin inhibitors and Factor X inhibitors are the most clinically advanced. This article discusses the recent advances in the development of novel targets of anticoagulants. Medline, EMBASE, cochrane database, medscape, SCOPUS, and clinicaltrials.gov were searched using terms "anticoagulants", "blood coagulation inhibitors", "anticoagulants and venous thromboembolism", "anticoagulants and atrial fibrillation", and "'antithrombins." Journal articles published from 2007 to 2012 discussing pharmacology and/or clinical trials were screened.
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Suruchi Aditya (2012) conducted a review in Need for anticoagulation. Novel anticoagulants vs. Traditional anticoagulants was evaluated. Direct thrombin inhibitors and Factor X inhibitors are the most clinically advanced among the novel anticoagulants targeting specific steps in the coagulation cascade.
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