Department of Hematology, Rambam Health Care Campus, Haifa, Israel.
Blood Rev. 2011 Sep;25(5):215-21. doi: 10.1016/j.blre.2011.04.003. Epub 2011 May 24.
The incidence of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is increasing and the disease has been found to account for over 500,000 annual deaths in the European Union. VTE is associated with increased mortality and may lead to serious long-term complications. Unfractionated heparin (UFH), low molecular weight heparin (LMWH) and vitamin K antagonists (VKA) have remained standard of care for many years. Recent trials of novel anticoagulants have indicated that new therapeutical options may soon become available. Studies on the role of new agents in VTE prevention in patients undergoing orthopaedic surgery have provided the evidence suggesting potential value of these drugs for the management of acute events. At present, investigation of new anticoagulants has reached the stage when phase III clinical studies on some novel agents have been completed and others are in progress. Of those furthest along are the direct Factor Xa inhibitors, rivaroxaban and apixaban, and the direct thrombin inhibitor, dabigatran. Findings of ongoing trials are expected to determine potential impact of these agents on current clinical practice.
静脉血栓栓塞症（VTE）的发病率正在上升，包括深静脉血栓形成和肺栓塞，据发现，该病在欧盟每年导致超过 50 万人死亡。VTE 与死亡率增加有关，并可能导致严重的长期并发症。未分级肝素（UFH）、低分子量肝素（LMWH）和维生素 K 拮抗剂（VKA）多年来一直是标准治疗方法。新型抗凝剂的最近试验表明，新的治疗选择可能很快就会出现。关于新型药物在骨科手术患者中预防 VTE 的作用的研究提供了这些药物在急性事件管理中具有潜在价值的证据。目前，对新型抗凝剂的研究已经进入某些新型药物的 III 期临床试验已经完成，其他药物正在进行中的阶段。其中进展最快的是直接 Xa 因子抑制剂利伐沙班和阿哌沙班，以及直接凝血酶抑制剂达比加群。正在进行的试验的结果预计将确定这些药物对当前临床实践的潜在影响。
