Nattokinase dabigatran has been approved for use in preventing VTE in patients

Nattokinase dabigatran has been approved for use in preventing VTE in patients who have undergone elective total hip and knee arthroplasty in Europe, Canada, and United States.63 In addition to VTE prophylaxis, the FDA approved dabigatran etexilate in 2010, for prevention of stroke in patients with nonvalvular atrial fibrillation64 after the results of the RE LY study. Conclusion For several decades, warfarin has been an exclusively available oral anticoagulation therapy. It has been proved to be an effective treatment in various clinical settings including VTE treatment and prophylaxis, stroke prevention in atrial fibrillation, and so on. However, there are several drawbacks to consider using warfarin including the need for dose monitoring and adjustment which tremendously complicates its clinical management. Until several years, novel anticoagulants drug screening libraries were released and they could potentially address these defectsassociated with warfarin. There are several aspects of novel anticoagulants that need to be addressed. The upcoming studies will be needed to investigate the potential role of these medications in other clinical settings, for example, postsurgical VTE prophylaxis in abdominal surgery, prosthetic heart valves, peripheral artery disease, and cerebrovascular diseases.
In addition to rivaroxaban, apixaban, and dabigatran etexilate, other FXa inhibitors are being evaluated. Otamixaban has completed high throughput chemical screening phase II trial for short term use in percutaneous coronary prevention64 and in non ST elevation acute coronary syndrome.65 The promising results are further verified in an ongoing phase III trial in patients with unstable angina or MI with non ST elevation undergoing early invasive strategy compared with unfractionated heparin, epifibatide, or matching placebo. In addition, idraparinux is a parental form of polysaccharide indirect FXa inhibitors with very long halflives 66 that were developed for once weekly dosing for several conditions that require long term or chronic therapy.67,68 These novel anticoagulants seem to have better efficacy and safety against VTE and stroke prevention in various clinical settings. However, there are some major disadvantages of these novel anticoagulants. First, they have no antidote in the case of drug overdose. Second, since most of them are excreted in the urine, they can potentially cause daunorubicin major bleeding in patients with renal dysfunction.
Therefore, using these novel anticoagulants may need careful monitoring in postmarketing surveillance studies for emerging side effects after FDA approvals.Despite initial positive response to androgen ablation therapy, virtually all patients with prostate cancer develop hormone refractory disease. The epidermal growth factor receptor or erbB1 is a proto oncogene, which primary encodes a 170 kDa protein consisting of an extracellular ligandbinding domain, a transmembrane domain, an intracellular tyrosine kinase domain, and a carboxy terminal regulatory domain containing sites of autophosphorylation. Upon the binding of its ligand, EGFR undergoes homo and/or heterodymerization with other members of the same receptor family, including erbB2, erbB3, and erbB4, resulting in the addition of phosphate moieties to specific tyrosines, which can serve as docking sites for downstream effectors.

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