Abstract

Dabigatran etexilate: an oral direct thrombin inhibitor

Author(s): Ola E Dahl

Dabigatran etexilate is a direct thrombin inhibitor that offers potential advantages over existing anticoagulants for the prevention and treatment of venous and arterial thrombosis. It is administered orally, has a rapid onset of action, a predictable anticoagulant effect and does not require laboratory monitoring. Trial results indicate that dabigatran etexilate has similar efficacy, risk of bleeding and tolerability compared with currently used anticoagulants. Dabigatran etexilate is approved in Europe and Canada for the prophylaxis of venous thromboembolism in patients undergoing hip- and kneereplacement surgery. Trials involving more than 40,000 patients are evaluating the safety and efficacy of dabigatran etexilate for the treatment of deep-vein thrombosis and pulmonary embolism, primary and secondary prevention of venous thromboembolism, prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, and prevention of cardiac events in patients with acute coronary syndromes. The drug may have its greatest impact in providing a much-needed and attractive alternative to vitamin K antagonists.