Rationale for the use of antifactor Xa in the treatment and prevention of venous and arterial thromboembolic events

The design and synthesis of new antithrombotic agents have led to numerous recent clinical trials to investigate their efficacy and safety. Analysis of the data from these trials, especially when the results were not totally expected, has provided interesting information, allowing a better understan...

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Bibliographic Details
Published in:European journal of clinical investigation 2005-03, Vol.35 (s1), p.21-26
Main Authors: Drouet, L., Bal dit Sollier, C.
Format: Article
Language:English
Subjects:
Anticoagulants - therapeutic use
Antifactor Xa
factor Xa
Factor Xa Inhibitors
fondaparinux
Heparin - therapeutic use
Humans
pathophysiology
Polysaccharides - therapeutic use
Postoperative Complications - drug therapy
Postoperative Complications - prevention & control
Thrombin - antagonists & inhibitors
Thrombin - physiology
Thromboembolism - drug therapy
Thromboembolism - physiopathology
Thromboembolism - prevention & control
thrombosis
Venous Thrombosis - drug therapy
Venous Thrombosis - physiopathology
Venous Thrombosis - prevention & control
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Summary:The design and synthesis of new antithrombotic agents have led to numerous recent clinical trials to investigate their efficacy and safety. Analysis of the data from these trials, especially when the results were not totally expected, has provided interesting information, allowing a better understanding of the pathophysiology of thrombosis in various clinical situations. The aim of the present manuscript is to present the hypotheses on thrombogenesis generated by some of these recent clinical trials, notably those investigating the antithrombotic efficacy of a new synthetic and selective factor Xa inhibitor, fondaparinux. The antithrombotic efficacy of fondaparinux was recently investigated in a number of trials in the prevention and treatment of venous and arterial thrombotic disorders. In each case, the concept of the clinical efficacy of a selective factor Xa inhibitor has been proven. These trials have also clarified the implication and mode of action of factor Xa in these various types of thrombotic events. In the light of these trials, we discuss the clinical efficacy of such a selective factor Xa inhibitor, and other specific points such as the apparent lack of dose‐dependency of its antithrombotic effect.
ISSN:0014-2972
1365-2362
DOI:10.1111/j.0960-135X.2005.01453.x