Abstract
Pentasachdiarides are heparin-derived drugs. They work by activating antithrombin, with the resulting complex targeting factor Xa.
Fondaparinux was used in the initial treatment of pulmonary embolism in the MATISSE-PE (Mondial Assessment of Thromboembolism treatment Initiated by Synthetic pentasaccharide with Symptomatic Endpoints - Pulmonary Embolism) trial and has proved to be comparably effective as unfractionated heparin (UFH). Long-acting pentasaccharide idrapahnux at a once weekly dose of 2.5 mg was compared with standard therapy In the Van Gogh trial.
Idraparinux therapy had controversial outcomes in patients with pulmonary embolism and its development was finished. Therefore, biotinylated idraparinux - idrabiotaparinux was synthesized, with biotin being incorporated in the molecule to rapidly stop the anticoagulation.
In the CASSIOPEA study (Clinical Study Assessing SSR126517E Injections Once-weekly in Pulmonary Embolism Therapeutic Approach), biotinylated idraparinux has proved to be effective and safe in the treatment of pulmonary embolism. Once-weekly biotinylated idraparinux appears to be an alternative to warfarin, gatrans, or xabans.