ABSTRACT
The anticoagulant drugs have an essential role in the prevention and treatment of
thromboembolic diseases. The currently available anticoagulants have several limitations,
including a narrow therapeutic window, the risk of bleeding complications and, for
some drugs, the need for laboratory monitoring and parenteral administration. These
limitations make the case for the development of new anticoagulants. An ideal anticoagulant
should be effective, safe, simple to use, and widely applicable. The new anticoagulants
currently under investigation are obtained by molecular technology that makes it possible
to target their effect toward a selected step of the coagulation cascade. Based on
their target, new anticoagulants can be classified into three groups: inhibitors of
activation of coagulation, inhibitors of propagation of coagulation, and inhibitors
of thrombin formation. Several new anticoagulants currently are in different phases
of development. Some of them have been approved for clinical use, others are in advanced
phase of clinical development, and some are still in the initial phase of investigation.
KEYWORDS
Anticoagulant therapy - antithrombotic therapy - anticoagulants - direct thrombin
inhibitors - factor Xa inhibitors
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Giancarlo AgnelliM.D.
Internal and Cardiovascular Medicine & Stroke Unit Department of Internal Medicine,
University of Perugia, Ospedale Silvestrini
06129 Perugia, Italy
Email: agnellig@unipg.it