Novel Anticoagulants: New Evidence for Emerging Drugs and Their Potential Application in Major Lower Limb Surgery
Bibliographic record
Abstract
For decades, parenteral drugs, such as the low molecular weight heparins and unfractionated heparins or vitamin K antagonists, have been used as anticoagulants for prevention of venous thromboembolism following major lower limb surgery. However, these regiments have limitations that rendered the quest for new anticoagulants mandatory. Recently, research has been focused on the development of orally active small molecules that directly target thrombin or activated factor X (FXa). These regiments exhibit a number of characteristics that an “ideal” anticoagulant should possess. Currently, two agents, dabigatran etexilate and rivaroxaban, which inhibit thrombin and FXa, respectively have been approved in the European Union and Canada for venous thromboprophylaxis in patients undergoing elective hip- or kneereplacement surgery. Other agents are at an early or late stage of clinical evaluation. In this study, we summarize the current evidence for these new developed or under development drugs regarding their applications in the filed of lower limb orthopaedic surgery. Keywords: Novel, anticoagulants, oral, deep vein thrombosis, lower, limb, parenteral drugs, molecular weight heparins, unfractionated heparins, vita-min K antagonists, tivated factor X (FXa), dabigatran etexilate, rivaroxaban, venus thromboembolism (VTE), TKR, HFS, prophylaxis, THR, pulmo-nary embolism (PE), meta-analyses, low-dose unfractionated heparin (LDUH), unfractionated heparin (UFH), throm boxane A2, heparin induced thrombocytopenia, such as warfarin, aspirin, pharmacokinetics, antidote will, antithrombin, factors II, VII, IX, X, proteins C, S, ser-ine proteases, cascade, thrombin, Fondaparinux, Arixtra, GlaxoSmithKline, syn-thetic pentasacharride, ACCP, Indraparinux (Sanofi-Aventis), atrial fibrillation, biotin, avidin, Xarelto, Bayer, Schering Pharma, Wuppertal, Germany, Apixaban, Bristol-Meyers Squibb, Pfizer, APROPOS, LY517717, YM150, Betrixaban, Edoxaban (DU, –, 176b), Ximelagatran, Dabigatran Etaxilate
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.009 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".