ANTITHROMBIN AGENTS AS ANTICOAGULANTS AND ANTITHROMBOTICS - IMPLICATIONS IN DRUG DEVELOPMENT

Synthetic and recombinant thrombin inhibitors have undergone several c linical evaluations for thrombotic and cardiovascular indications. Whi le the initial trials were focused in coronary indications, more recen tly, these agents are also developed for the prophylaxis and therapeut ic management of thromboembolic disorders. Hirudin, PEG-hirudin and ar gatroban are in advanced clinical development. Recombinant hirudin has been approved in Europe as a substitute anticoagulant for the managem ent of HIT patients. Several additional clinical trials are currently carried out to demonstrate the usefulness of these agents in thromboti c and cardiovascular indications. Despite these developments such issu es as dosage optimization, laboratory monitoring, neutralization and d rug interactions require additional studies fbr the optimal developmen t of these drugs.