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Clinical experience with direct thrombin inhibitors in the prevention and treatment of deep vein thrombosis (DVT) Volume 12, issue 7, Août - Septembre 2000

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  • Page(s) : 440-7
  • Published in: 2000

Of all the direct antithrombin agents even hirudin, which has been known (and used) for the longest time can, provide surprising high efficacy in preventing deep vein thrombosis after orthopedic surgery. This effect at relatively moderate doses (without any significant hemorrhagic risk) is probably related to the high affinity of hirudin for bound thrombin. The newer synthetic antithrombin agents differ one from another (and from hirudin) by the affinity for thrombin, their molecular weight, their PK and their PD characteristics. Only appropriate dose finding and rigorous clinical trials will determine their relative clinical indications and efficacy. The orally active synthetic antithrombin agents (melagatran) are raising interest in particular in new antithrombotic agents and strategies.