New anticoagulants for the prevention and treatment of venous thromboembolism

Abstract

Anticoagulant therapy is effective at preventing the development of venous thromboembolism in high-risk patients, and reduces morbidity and mortality in individuals with established thromboembolic disease. Vitamin K antagonists and heparins are currently the most commonly used anticoagulant drugs, but they have practical limitations. Therefore, new antithrombotic agents with predictable dose-responses (thereby decreasing the need for monitoring without compromising efficacy or safety), ideally available in an oral formulation and with a rapidly reversible anticoagulant effect, are needed. New drugs fulfilling some of the above criteria have been developed and have proven to be effective agents for the treatment and prevention of venous thromboembolism.

Figure 1

The coagulation cascade and sites of action of new drugs. Abbreviations: APC, activated protein C; DTI, direct thrombin inhibitors; PL, phospholipids; STM, soluble thrombomodulin; TFPI, tissue factor pathway inhibitor.