The role of recombinant hirudins in the management of thrombotic disorders

BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Karl-Georg Fischer

Abstract

Native hirudin is the most potent natural direct thrombin inhibitor currently known; it is capable of inhibiting not only fluid phase, but also clot-bound thrombin. Recombinant technology now allows production of recombinant hirudins (r-hirudins), which are available in sufficient purity and quantity with essentially unaltered thrombin-inhibitory potency. As thrombin is known to play a key role in a number of thrombotic disorders, numerous studies focused on the impact of r-hirudins on the clinical course in these diseases. R-hirudins provided significantly more stable anticoagulation than standard heparin, but demonstrated a relatively narrow therapeutic range with relevant bleeding risk even at clinically effective doses. In doses that are not associated with an increased bleeding risk, r-hirudins often failed to demonstrate significant superiority to heparin. To date, r-hirudins have a definite role in the treatment of heparin-induced thrombocytopenia, where they markedly reduce the high risk of thrombosis. For prophylaxis of deep vein thrombosis, r-hirudins have been shown to be superior to both unfractionated and low molecular weight heparin, but are not extensively used in this indication. In acute coronary syndromes, a d...Continue Reading

References

Jun 15, 1992·Thrombosis Research·G NowakF Markwardt
Jan 23, 1992·The New England Journal of Medicine·V FusterJ H Chesebro
Jan 30, 1992·The New England Journal of Medicine·V FusterJ H Chesebro
Jan 1, 1991·Haemostasis·F Markwardt
Aug 12, 1986·Biochemistry·S R Stone, J Hofsteenge
Mar 5, 1987·The New England Journal of Medicine·D B CinesS Tannenbaum
Dec 1, 1995·Journal of the American College of Cardiology·H J RupprechtJ Meyer
Jun 1, 1994·Kidney International·R C VanholderS Ringoir
Jul 1, 1994·Coronary Artery Disease·A Shaknovich
Dec 15, 1993·The Biochemical Journal·J BichlerS R Thorpe
Sep 12, 1996·The New England Journal of Medicine·UNKNOWN Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb investigators
Jan 1, 1996·Seminars in Thrombosis and Hemostasis·G Nowak, E Bucha
Jun 1, 1996·Coronary Artery Disease·R ChallapalliE J Topol
Nov 1, 1996·The American Journal of Medicine·T E Warkentin, J G Kelton
Jun 5, 1997·The New England Journal of Medicine·UNKNOWN Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Inv
Jan 1, 1997·Seminars in Thrombosis and Hemostasis·J HarenbergD L Heene
Jun 1, 1997·Thrombosis Research·B PötzschG Müller-Berghaus
Jul 1, 1997·Clinical Pharmacology and Therapeutics·G LefèvreP Close
Feb 12, 1998·The New England Journal of Medicine·O H Schmidt, W Lang
Mar 1, 1997·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·J AmiralD Meyer
Jun 4, 1998·Thrombosis Research·K T Preissner, D Seiffert
Jul 8, 1998·Lancet·J J Goy, E Eeckhout

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Citations

Apr 1, 2006·Expert Opinion on Therapeutic Patents·Samuel Chackalamannil, Yan Xia
Mar 7, 2006·Expert Review of Medical Devices·Gemma ConnAlexander M Seifalian
Sep 24, 2011·International Journal of Inflammation·Arthur J Chu
Feb 26, 2010·Thrombosis Research·Birgitta SalmelaRiitta Lassila
Oct 27, 2010·Journal of Biomedicine & Biotechnology·A M Tanaka-AzevedoA S Tanaka
Nov 17, 2009·Journal of Clinical Pharmacology·Anne N Nafziger, Joseph S Bertino
Aug 11, 2018·Biotechnology & Genetic Engineering Reviews·Jianguo Zhang, Nana Lan

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