Ximelagatran for prevention and treatment of venous thromboembolism.

Ximelagatran (Exanta (TM)) is the first oral agent in a new class of anticoagulants called direct thrombin inhibitors. Most of the available evidence regarding venous thromboembolism is from studies focusing on its prevention after major orthopedic surgery. Ximelagatran's efficacy is comparable to that of warfarin and low-molecular-weight heparin in this setting. The rates of bleeding complications for ximelagatran and its comparators were not statistically different. The elevation of liver enzymes was observed in longer term trials.