New challenges for a second-generation low-molecular-weight heparin: focus on bemiparin
New challenges for a second-generation low-molecular-weight heparin: focus on bemiparin
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DOI：
10.1586/erc.10.35
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发表时间：
2010-01-01
影响因子：
2
通讯作者：
Rodriguez, Cristina
中科院分区：
文献类型：
--
作者：
Martinez-Gonzalez, Jose;Rodriguez, Cristina
贝米肝素是第二代低分子量肝素（LMWH），具有最低的分子量、最长的半衰期和最高的抗因子Xa/抗因子IIa活性比。贝米肝素的安全性和有效性已在多项研究中得到证实，目前已获准用于治疗和预防静脉血栓栓塞（VTE），以及预防血液透析期间体外回路中的凝血。在西班牙国家卫生系统进行的多中心药物经济学研究表明，贝米肝素在预防全膝关节置换术中的VTE方面比依诺肝素更具成本效益。有趣的是，最近的结果表明，贝米肝素可能是有用的辅助治疗下肢糖尿病溃疡的管理。由于国际指南建议低分子肝素用于VTE癌症患者的初始和持续抗凝治疗以及预防，因此正在进行的试验结果对于确定贝米肝素在肿瘤患者中的潜力至关重要。最后，目前正在I期试验中分析两种口服贝米肝素制剂的药代动力学。
Bemiparin is a second-generation low-molecular-weight heparin (LMWH) that has the lowest molecular weight, the longest half-life and the highest anti-Factor Xa/anti-Factor IIa activity ratio. The safety and efficacy of bemiparin has been demonstrated in several studies and currently it is licensed for the treatment and prophylaxis of venous thromboembolism (VTE), as well as for the prevention of clotting in the extracorporeal circuit during hemodialysis. Multicenter pharmacoeconomic studies carried out in the Spanish National Health system indicate that bemiparin is more cost effective than enoxaparin for the prevention of VTE in total knee replacement. Interestingly, recent results suggest that bemiparin could be useful as an adjuvant treatment in the management of lower-extremity diabetic ulcers. Since international guidelines recommend LMWHs for initial and continuous anticoagulant treatment in cancer patients with VTE, as well as for its prevention, results from ongoing trials could be critical to establish the potential of bemiparin in oncological patients. Finally, the pharmacokinetics of two oral bemiparin formulations are currently being analyzed in a Phase I trial.