15492
document
Future therapeutic directions for factor Xa inhibition in the prophylaxis and treatment of thrombotic disorders . The targeted mechanism of factor Xa inhibition has been studied extensively , initially as prophylaxis for venous thromboembolism ( VTE ) in the orthopedic surgical setting . Future therapeutic directions for selective factor Xa inhibition in the management of other thrombotic diseases are discussed . Thromboembolic diseases can occur in the venous or arterial sides of the circulatory system . Factor Xa inhibition is a targeted approach to anticoagulation that resulted from significant advances in our understanding of the coagulation cascade . The factor Xa inhibitor fondaparinux has been studied extensively in the orthopedic surgical setting for the prophylaxis of VTE . Current investigations that are under way or completed evaluate the efficacy and safety of fondaparinux for the management of various thrombotic diseases . The future development of fondaparinux resides primarily in three therapeutic areas : prevention of VTE , treatment of VTE , and treatment of acute coronary syndromes . For the prevention of VTE , fondaparinux has been studied as extended prophylaxis following hip fracture surgery ( PENTHIFRA Plus ) , for use in high-risk abdominal surgical patients ( PEGASUS and APOLLO ) , and for use in medical patients ( ARTEMIS ) . Studies evaluating fondaparinux for the treatment of VTE are part of the large MATISSE clinical program ( MATISSE DVT and MATISSE PE ) . Fondaparinux was investigated in phase 2 studies for the treatment of acute coronary syndromes , including acute ST-segment myocardial infarction ( PENTALYSE ) and unstable angina ( PENTUA ) . Encouraging data from these trials are the basis for phase 3 programs in this area ( MICHELANGELO ) . The orthopedic prophylactic and nonorthopedic clinical programs for fondaparinux in the management of thrombosis support the concept that targeted inhibition of coagulation is an effective advance in antithrombotic therapy .
15493
Intervention_Pharmacological
factor Xa inhibitor fondaparinux
15494
Intervention_Pharmacological
fondaparinux
15495
Intervention_Pharmacological
fondaparinux
15496
Intervention_Pharmacological
Fondaparinux
15497
Outcome_Other
efficacy and safety
15498
Outcome_Physical
acute coronary syndromes
15499
Outcome_Physical
acute ST-segment myocardial infarction ( PENTALYSE ) and unstable angina ( PENTUA )
15500
Outcome_Physical
targeted inhibition of coagulation
15501
Participant_Condition
thrombotic disorders .
15502
Participant_Condition
venous thromboembolism ( VTE )
15503
Participant_Condition
acute coronary syndromes