NEW ORAL ANTICOAGULANTS UNDER STUDY

A host of new oral anticoagulantagents, which could becomemuch-needed replacementsfor warfarinand be used as alternativesto heparin,are under development.Two of theseagents are now inphase 3 trials. Expertsare cautious,however, followingthe failure of the first such agent, ximelagatran,to reach the US market becauseof liver-toxicity issues. Researchersare optimistic that at least 1or 2 of the new compounds will succeedand provide patients who are takingwarfarin with a much more userfriendlytreatment.

The 2 agents furthest in developmentare the factor IIa inhibitor dabigatran(Boehringer Ingelheim) and the factorXa inhibitor rivaroxaban (BayerHealthCare and Ortho-McNeil PharmaceuticalsInc). Several other companiesalso have orally available factor Xainhibitors in earlier clinical development,including Bristol-Myers SquibbCo, Eli Lilly and Co, Yamanouchi PharmaceuticalCo, and DuPont PharmaceuticalsCo.

Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Carein High Point, NC.