Danny Hsu: The Next Frontier in Anticoagulation Beyond DOACs
Danny Hsu, President of THANZ, shared Journal of Thrombosis and Haemostasis‘ post on LinkedIn:
“Beyond DOACs: The Next Frontier in Anticoagulation!
We must always look to the horizon!
Thrombotic manifestations remain the leading cause of death worldwide, making our therapeutic and prophylactic strategies more critical than ever.
Thanks to Holly Dobbing, Robert Ariens from University of Leeds for a look into the crystal ball!!!
Here is a look at the exciting developments brewing in the pipeline:
- Factor XI (FXI) Leads the Pack:
FXI inhibitors are currently the most progressed in development, with ongoing phase III trials.
These inhibitors are showing safety profiles equal or superior to current treatments, alongside promising efficacy in VTE prophylaxis.
However, their effectiveness in arterial thrombosis appears less potent, which is a key area for future investigation.
- The Preclinical Challengers:
Targeting FV, FVIII, FIX, and FXIII presents complex challenges and remains largely in the preclinical stages.
For instance, direct FXIIIa inhibitors show great potential but are currently limited by reduced selectivity and off-target effects.
- Harnessing Natural Mechanisms:
Exploring endogenous anticoagulant and fibrinolytic mechanisms offers exciting new therapeutic opportunities.
A deeper understanding of mechanisms involving Protein S and FV-short may support viable future options.
- Evolving Thrombolytics:
While alteplase and tenecteplase remain key therapies, novel approaches like catheter-mediated delivery and targeting TAFI or alpha-2-antiplasmin are demonstrating early promise for safety and efficacy improvements.
Despite the inherent complexity of our coagulation and fibrinolytic pathways, they offer numerous targets for novel interventions.
The next phase of leading-edge anticoagulants and fibrinolytics will allow us to specifically target mechanisms that deliver optimal efficacy and safety for our patients.
What emerging target are you most excited to see translated into clinical practice?”
Journal of Thrombosis and Haemostasis shared a post on LinkedIn about a recent article by Holly C. Dobbing et al, adding:
“Novel and Experimental Anticoagulant Strategies Beyond Current DOACs
Emerging anticoagulation strategies explore contact pathway inhibition, fibrin targeting, and natural anticoagulant pathway enhancement to address DOAC limitations, promising safer thrombosis treatment with reduced bleeding risks for cardiovascular disease management.”
Title: Novel and experimental anticoagulant strategies beyond current direct oral anticoagulants
Authors: Holly C. Dobbing, Katherine L. Webb, Robert A.S. Ariëns
Read the Full Article on Journal of Thrombosis and Haemostasis
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