Lassen Michael Rud, Laux Volker
Department of Orthopaedics and Clinical Trial Unit, Nordsjaellands Hospital Hørsholm, University of Copenhagen, Usserød Kongevej 102, Hørsholm, Denmark.
Vasc Health Risk Manag. 2008;4(6):1373-86. doi: 10.2147/vhrm.s3266.
In Western countries, venous thromboembolism (VTE) is a widespread and serious disorder, with hospital admission rates that appear to be increasing. Current anticoagulant therapies available for the prevention and treatment of VTE have several drawbacks that make them either difficult to manage effectively, due to a need for careful monitoring to control coagulation, or, in the case of parenterally administered agents, inconvenient for long-term use. To address some of these issues, new anticoagulants are in clinical development that can be orally administered and directly target specific factors in the coagulation cascade. This article reviews the rationale behind development of these novel agents and provides a critical appraisal of their clinical potential. In addition, the impact that the introduction of such agents into clinical practice would have is discussed from the patient perspective.
在西方国家,静脉血栓栓塞症(VTE)是一种普遍且严重的疾病,其住院率似乎在不断上升。目前可用于预防和治疗VTE的抗凝疗法存在若干缺点,这些缺点使得它们要么因需要仔细监测以控制凝血而难以有效管理,要么就注射用药物而言,长期使用很不方便。为了解决其中一些问题,新型抗凝剂正在进行临床开发,这些抗凝剂可以口服,并直接作用于凝血级联反应中的特定因子。本文回顾了这些新型药物开发背后的基本原理,并对其临床潜力进行了批判性评估。此外,还从患者角度讨论了将此类药物引入临床实践可能产生的影响。