Never miss out on the latest news!
Sign up to the Thrombosis Adviser newsletter.
Direct Thrombin Inhibitors
This section covers the role of thrombin in coagulation, and discusses the use of direct thrombin inhibitors as anticoagulants
In this section:
The role of thrombin in coagulation
Thrombin plays a key role in coagulation.1 During the propagation phase, activated Factor X converts large amounts of prothrombin to thrombin, initiating a ‘thrombin burst’
PL, phospholipid
The direct thrombin inhibitor dabigatran and its approved indications
- Dabigatran is a competitive, reversible direct thrombin inhibitor3
- It inhibits free thrombin, fibrin-bound thrombin and thrombin-induced platelet aggregation
- Inhibition of thrombin prevents the conversion of fibrinogen to fibrin and thus clot formation
- Dabigatran is orally administered as the prodrug dabigatran etexilate, which is converted to the active form in plasma and in the liver
- Dabigatran is approved in Europe in adults for:3
- Prevention of VTE in patients undergoing elective hip or knee replacement surgery
- Treatment of DVT and PE and prevention of recurrent DVT and PE (following initial parenteral anticoagulation for at least 5 days)
- Prevention of stroke and systemic embolism in patients with NVAF with ≥1 risk factors
References
- Hoffman M, Monroe DM. Coagulation 2006: a modern view of hemostasis. Hematol Oncol Clin North Am 2007;21:1–11. Return to content
- Mann KG, Brummel K, Butenas S. What is all that thrombin for? J Thromb Haemost 2003;1:1504–1514. Return to content
- Boehringer Ingelheim International GmbH. Pradaxa® (dabigatran etexilate) Summary of Product Characteristics. 2018. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000829/WC500041059.pdf [accessed 22 August 2018]. Boehringer Ingelheim International GmbH. Pradaxa® (dabigatran etexilate) Summary of Product Characteristics. 2018. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000829/WC500041059.pdf [accessed 22 August 2018]. Return to content
