Fondaparinux sodium - Anticoagulant - Factor Xa inhibitor - Treatment and prevention of deep vein thrombosis

Although a number of antithrombotics have been developed in recent years, deep venous thrombosis and arterial thrombosis are still a major cause of morbidity and mortality in developed countries, and the search for better antithrombotic agents continues. Fondaparinux is a synthetic pentasaccharide that potently and selectively inhibits factor Xa. Such compounds are expected to have advantages over thrombin inhibitors, i.e., a higher safety margin and less frequent monitoring. Fondaparinux exerts concentration-dependent anticoagulant activity in vitro in human whole blood, while having little or no effect on prothrombin time, thrombin clotting time, activated partial thromboplastin time or platelet aggregation. Antihrombotic effects have been demonstrated in animal models of both venous and arterial thrombosis. Fondaparinux proved to be safe and effective in phase 11 and III clinical trials for the prevention and treatment of venous and arterial thrombosis. Further studies are under way which should help to better define its role in specific clinical indications. For now, the pentasaccharide has been approved by the FDA for use in the prophylaxis of deep vein thrombosis in patients undergoing hip fracture, hip replacement or knee replacement surgery.