Zalpour Ali, Kroll Michael H, Afshar-Kharghan Vahid, Yusuf Syed Wamique, Escalante Carmen
Pharmacy Clinical Programs, Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Adv Hematol. 2011;2011:196135. doi: 10.1155/2011/196135. Epub 2011 Oct 15.
The association between cancer and venous thromboembolism (VTE) has been well documented in the literature. Prevention and treatment of VTE in cancer patients is imperative. Typically, the mainstay regimen for VTE prevention and treatment has been anticoagulation therapy, unless contraindicated. This therapy consists of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), factor Xa inhibitor, or vitamin K antagonist (VKA). Current guidelines recommend LMWH over VKA for the treatment of VTE in cancer patients. Factor-specific anticoagulants have been proven safe and effective, and recently factor Xa inhibitors have emerged as a treatment alternative to heparins and VKA. Currently, three factor Xa inhibitors have been identified: fondaparinux (the only one approved so far by the US Food and Drug Administration), idraparinux (in clinical trials), and idrabiotaparinux (in clinical trials). This paper will examine the role of these agents, focusing on fondaparinux, for the prevention and treatment of VTE in cancer patients.
癌症与静脉血栓栓塞（VTE）之间的关联在文献中已有充分记载。癌症患者VTE的预防和治疗势在必行。通常，除非有禁忌证，VTE预防和治疗的主要方案一直是抗凝治疗。这种治疗包括普通肝素（UFH）、低分子量肝素（LMWH）、Xa因子抑制剂或维生素K拮抗剂（VKA）。当前指南推荐在癌症患者VTE治疗中使用LMWH而非VKA。因子特异性抗凝剂已被证明安全有效，最近Xa因子抑制剂已成为肝素和VKA的一种治疗替代方案。目前，已确定三种Xa因子抑制剂：磺达肝癸钠（是迄今为止唯一被美国食品药品监督管理局批准的一种）、依达肝素（处于临床试验阶段）和艾卓肝素（处于临床试验阶段）。本文将探讨这些药物在癌症患者VTE预防和治疗中的作用，重点关注磺达肝癸钠。
