otamixaban and Coronary-Artery-Disease

As coronary artery disease (CAD) remains a leading cause of death in the world, the development of anti-coagulants to prevent CAD progressing to myocardial infarction and death is a high priority. A number of direct Factor Xa (FXa) inhibitors are being developed for use in CAD. Despite being developed to the stage of Phase II clinical trials, DX-9065a is no longer a priority with its developing company for further development, possibly because the Phase II trials did not show any major benefit of DX-9065a over heparin in subjects undergoing percutaneous coronary interventions (PCI) or with non-ST-elevation acute coronary syndromes (ACS). ZK-807834, otamixaban, apixaban, and rivaroxaban are all direct FXa inhibitors that have undergone preclinical and some clinical testing for use in CAD. In a large Phase II clinical trial of subjects with ACS, some doses of otamixaban had a better benefit/risk profile than the unfractionated heparin/eptifibatide combination. However, neither ZK-807834 nor otamixaban appear to be undergoing further clinical development at present. In ACS, placebo-controlled large Phase II clinical trials with apixaban and rivaroxaban have not shown clear cut benefits. Nevertheless, apixaban and rivaroxaban are presently in placebo-controlled Phase III clinical trials for ACS. Presently, there is no compelling evidence to support the use of direct FXa inhibitors in ACS.

Topics: Amidines; Coronary Artery Disease; Cyclic N-Oxides; Factor Xa; Factor Xa Inhibitors; Humans; Morpholines; Naphthalenes; Propionates; Pyrazoles; Pyridines; Pyridones; Rivaroxaban; Thiophenes

Topics: Angioplasty, Balloon, Coronary; Anticoagulants; Coronary Artery Disease; Cyclic N-Oxides; Factor IXa; Fondaparinux; Heparin; Hirudins; Humans; Peptide Fragments; Polysaccharides; Pyridines; Recombinant Proteins