A Review on Novel Therapeutic Approaches for Prevention and Treatment of Deep Vein Thrombosis

D. Ravi Kiran*
Department of  Pharmacy Practice, Creative Educational Society College of Pharmacy, Chinna Tekuru, Kurnool, Andhra Pradesh, India

A B S T R A C T
Venous thromboembolism includes pulmonary embolism (PE), which is potentially fatal and causes chronic thromboembolic pulmonary hypertension, and deep vein thrombosis, which causes leg swelling and postthrombotic syndrome. In addition, VTE may develop in a splanchnic vein and in other atypical locations. Currently, cancer-associated thrombosis is highlighted due to the increased prevalence of cancer. Inadequate anticoagulation (inadequate dosage, poor compliance, discontinuation for an anticipated procedure, malabsorption) is the most common cause of recurrent Venous thromboembolism during therapy. However, recurrent Venous thromboembolism should be confirmed by radiologic testing and should be examined for other etiologies, such as malignancy, May-Thurner syndrome, inherited thrombotic disorders, or antiphospholipid antibody syndrome. Treatment options for initial failure include increasing the dose or administration frequency of the anticoagulants or alternate agents. Idarucizumab is an engineered antibody fragment with a structure similar to that of thrombin; it binds to dabigatran. Andexanet alfa is a modified, recombinant human factor Xa protein that binds to factor Xa inhibitors and low molecular weight heparin but is catalytically inactive. Novel antithrombotic agents, with more specific activity on the coagulation cascade, more predictable pharmacodynamics and pharmacokinetics, simpler dosing regimens, and few or no laboratory monitoring requirements, have been developed to overcome limitations associated with some of the nonspecific traditional anticoagulants. Unfractionated heparin and low molecular weight heparin are currently the recommended options for initial anticoagulation in patients with acute thromboembolism. Warfarin is the most commonly used agent for chronic anticoagulation. 
Keywords: Venous thromboembolism, pulmonary embolism, pulmonary hypertension, malabsorption, pharmacodynamics and pharmacokinetics, anticoagulation.