Review
Hematology
Amy L. Kiskaddon, Nhue L. Do, Pamela Williams, Marisol Betensky, Neil A. Goldenberg
Summary: This systematic review examined the use of intravenous direct thrombin inhibitors (DTI) in pediatric extracorporeal membrane oxygenation (ECMO) and identified bivalirudin as the most frequently used DTI. However, dosing and laboratory monitoring varied among the studies, and bleeding and thromboembolic events were observed in approximately 17% of patients. Prospective studies are needed to establish the optimal dosing, monitoring, safety, and efficacy of bivalirudin and other intravenous DTIs in pediatric ECMO.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2023)
Review
Hematology
Amy L. Kiskaddon, Nhue L. Do, Pamela Williams, Marisol Betensky, Neil A. Goldenberg
Summary: This systematic review examined the use of intravenous direct thrombin inhibitors (DTI) in pediatric extracorporeal membrane oxygenation (ECMO). The study found that bivalirudin was the most commonly used DTI in this population. Dosing and laboratory monitoring varied, and a percentage of patients experienced bleeding and thromboembolic events. Prospective studies are needed to establish the optimal dosing, monitoring, safety, and efficacy of DTIs in pediatric ECMO.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2023)
Article
Cardiac & Cardiovascular Systems
Christine S. Ji, Russel J. Roberts, Megan E. Barra, Hang Lee, Rachel P. Rosovsky
Summary: This study evaluated the safety and efficacy of direct thrombin inhibitors (DTIs) during a heparin shortage, finding that while there was an increase in the use of DTIs within the initial 48 hours of therapy, there were no significant differences in patient safety and effectiveness.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Review
Biochemistry & Molecular Biology
Hannah L. McRae, Leah Militello, Majed A. Refaai
Summary: Heparin and warfarin were traditionally used as primary anticoagulants, but the emergence of newer oral and parenteral anticoagulants has led to shifts in practice guidelines and monitoring needs, creating challenges in knowledge and resources for urgent reversal and monitoring in clinical scenarios.
Article
Critical Care Medicine
Troy G. Seelhammer, John K. Bohman, Phillip J. Schulte, Andrew C. Hanson, Devon O. Aganga
Summary: The study compared the effects of conventional heparin and bivalirudin anticoagulants in adult and pediatric patients receiving extracorporeal membrane oxygenation support. The adult group using bivalirudin showed reduced hospital mortality, while the pediatric group had decreased transfusion requirements in the first 24 hours. No significant differences were found between the two groups in terms of age, sex, and treatment-related complications.
CRITICAL CARE MEDICINE
(2021)
Article
Pharmacology & Pharmacy
Bing Zhao, Mengfang Wu, Zhihuang Hu, Tianfa Wang, Jinchao Yu, Yixin Ma, Qi Wang, Yanling Zhang, Di Chen, Tianyu Li, Yaran Li, Min Yu, Huijie Wang, Wei Mo
Summary: Thrombin expression in NSCLC tissues is closely related to clinicopathological features and patient prognosis. Thrombin deficiency inhibits tumor progression. Novel thrombin inhibitors, r-hirudin and DTIP, inhibit cancer cell invasion and metastasis, and combination with chemotherapy shows potential for improving therapeutic effects.
BRITISH JOURNAL OF PHARMACOLOGY
(2022)
Review
Hematology
Joseph R. Shaw, Lana A. Castellucci, Deborah Siegal, Marc Carrier
Summary: Direct oral anticoagulants (DOACs) are widely used as oral anticoagulants. DOAC-associated bleeding events are common and have significant morbidity and mortality. Managing DOAC-associated bleeding involves specific reversal agents and nonspecific hemostatic therapies, such as prothrombin complex concentrates. However, measuring the efficacy of these therapies in bleeding patients is challenging. Thrombin generation assays have emerged as a promising modality to evaluate the impact of DOACs on coagulation and the effects of hemostatic therapies on DOAC-altered thrombin generation parameters.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Hematology
Angela Lee, Frank Oley, Mimi Lo, Richard Fong, Mary McGann, Ila Saunders, Shanna Block, Anjlee Mahajan, Tiffany K. Pon
Summary: This study found no significant differences in safety and efficacy between DOACs and LMWH for the treatment of cancer-associated VTE. This suggests that DOACs may be a safe and effective option for VTE treatment in patients with primary or secondary brain tumors.
THROMBOSIS RESEARCH
(2021)
Review
Emergency Medicine
Ravi Sarode, Ian J. Welsby, Maureane Hoffman
Summary: Direct oral anticoagulants (DOACs) are commonly used for preventing and treating venous thromboembolism and stroke. In cases where emergency reversal of DOAC-related anticoagulation is needed, specific DOAC reversal agents such as idarucizumab and andexanet alfa are recommended. However, these specific reversal agents may not always be available, and the use of four-factor prothrombin complex concentrates (4F-PCCs) as alternative hemostatic agents for controlling DOAC-related bleeding is being explored. This review discusses the current evidence and expert opinion on the use of 4F-PCCs in clinical practice.
ANNALS OF EMERGENCY MEDICINE
(2023)
Article
Chemistry, Analytical
Xinxin Jiang, Yue Li, Hongmei Liu, Qin Zhang, Dandan Li, Wanglisha Zhu, Yanping He, Guoqi Zhang, Yan Zhao
Summary: A simple and sensitive fluorometric assay based on nitrogen-doped carbon dots (N-CDs) was developed for the determination of thrombin (TB) activity in human serum samples and living cells. The N-CDs exhibited green fluorescence and a high fluorescence quantum yield. TB hydrolyzed a specific substrate, leading to fluorescence quenching of the N-CDs. The assay showed a low detection limit for TB activity and could be used for TB inhibitor screening and activity determination in living cells.
Article
Hematology
Erika J. Martin, Melinda E. Nolte, Janice Kuhn, Nicole Schmidt, Nils Pfaff, Donald F. Brophy
Summary: The study showed that befovacimab had dose-dependent pro-coagulant effects in vitro, with concentrations of 5 to 10 nM demonstrating similar effects on coagulation as blood samples supplemented with rFVIII 10 to 40%.
Article
Biochemistry & Molecular Biology
HuiQun Du, MengHan Chang, JunLiang Zhang, Hao Zhou, Xin Shi, Xing Zhou
Summary: By integrating proximity ligation and rolling circle amplification, researchers have developed a unique and accurate method for detecting thrombin. This method can be used for the diagnosis and treatment of trauma, providing a valuable tool for thrombin-related applications.
MOLECULAR BIOTECHNOLOGY
(2023)
Article
Chemistry, Physical
Atul N. Khadse, Hardik H. Savsani, Rupesh V. Chikhale, Rahul B. Ghuge, Dixit R. Prajapati, Goshiya Kureshi, Prashant R. Murumkar, Kirti V. Patel, Sadhana J. Rajput, Mange Ram Yadav
Summary: Direct inhibition of FXa has been proven effective in anticoagulation with minimal bleeding risks. A novel series of anthranilamide derivatives were designed and synthesized to improve selectivity and physicochemical properties. These compounds showed potent FXa inhibitory activities and high selectivity over thrombin, as well as good anticoagulant activity and safety in animal models.
JOURNAL OF MOLECULAR STRUCTURE
(2022)
Review
Obstetrics & Gynecology
Ana Luisa Areia, Anabela Mota-Pinto
Summary: The use of direct oral anticoagulants (DOACs) during pregnancy poses safety concerns despite their practical advantages over low molecular weight heparin. A systematic review of studies on DOACs usage in pregnancy found a higher rate of fetal loss and fetal abnormalities compared to LMWH, although bleeding complications were similar.
JOURNAL OF PERINATAL MEDICINE
(2022)
Article
Pathology
Rida A. Hasan, Jennifer Pak, Christa Jefferis Kirk, Joshua M. Friedland-Little, Wayne L. Chandler
Summary: The plasma diluted thrombin time (dTT) showed a more stable dose-response relationship and stronger correlation with DTI dose compared to activated partial thromboplastin time (aPTT) in pediatric patients receiving argatroban and bivalirudin. The variation in dose-response curves was higher for argatroban compared to bivalirudin.
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
(2023)
