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Primera experiencia con la inhibición directa del factor Xa en pacientes con enfermedad coronaria estable: una
Christopher K Dyke1, Richard C Becker, Neal S Kleiman
1Duke Clinical Research Institute, Durham, NC 27715, USA.
Circulation
|May 22, 2002
Resumen
Este estudio evaluó DX-9065a, un nuevo inhibidor del factor Xa, en pacientes con enfermedad coronaria estable. El anticoagulante mostró un perfil de seguridad favorable con sangrado mínimo, lo que respalda una mayor investigación en la atherothrombosis.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Farmacología Farmacología.
- Hematología Hematología.
Sus antecedentes:
- La generación de trombina es clave en la formación de trombos arteriales después de la ruptura de la placa aterosclerótica.
- Se estudiaron pacientes con enfermedad coronaria estable en terapia estándar.
- DX-9065a es un nuevo inhibidor del factor Xa de molécula pequeña, directo, selectivo y reversible.
Objetivo del estudio:
- Evaluar la farmacocinética, la farmacodinámica y la seguridad de DX-9065a.
- Para evaluar el potencial de DX-9065a en el tratamiento de la atherothrombosis coronaria.
Principales métodos:
- Un ensayo doble ciego en el que participaron 73 pacientes con enfermedad coronaria estable.
- Los pacientes recibieron placebo o uno de los cuatro regímenes de DX-9065a ajustados por peso a través de un bolo intravenoso e infusión.
- Se recogieron muestras de plasma durante la infusión y un período de eliminación de 24 horas.
Principales resultados:
- La hemorragia menor, principalmente ecquimosis, se produjo de manera similar en todos los grupos, incluido el placebo.
- No se observaron cambios significativos en la hemoglobina, el recuento de plaquetas, la creatinina o las pruebas de función hepática.
- Los niveles plasmáticos del fármaco se correlacionaron fuertemente con la actividad del antifactor Xa, el tiempo de protrombina y la relación normalizada internacional.
Conclusiones:
- Este es el primer estudio de un inhibidor selectivo, reversible y directo de pequeñas moléculas del factor Xa en esta población de pacientes.
- Los hallazgos proporcionan una base para investigar los inhibidores del factor Xa en el tratamiento de la atherothrombosis coronaria.
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