List of drugs used in SCD patients to inhibit coagulation factors and platelets
| Name of drugs . | Mechanism of action . | Outcomes in SCD patients . |
|---|---|---|
| Warfarin, dicumarol | Inhibit coagulation factors thrombin, FVII, FIX, FX, protein C and S through blocking reuse of vitamin K | Warfarin modestly reduced the frequency of VOC (1.3-0.9 per year)57 |
| Acenocoumarol | Long-term administration of dicumarol reduced leg ulcers but did not affect VOC58 | |
| Administration of acenocoumarol for 14 wk showed 3 VOC whereas 5 VOC during placebo133 | ||
| Rivaroxaban | FXa inhibitor | Pending outcome (NCT02072668) |
| Apixaban | FXa inhibitor | Pending outcome (NCT02179177) |
| Heparin | Thrombin inhibitor | Days of hospitalization per year and hours spent in emergency rooms per year were reduced to 73% and 74%, respectively55 |
| Tinzaparin | Thrombin inhibitor | Tinzaparin treatment reduced the number of days with severe pain score (1.3 vs 1.7), overall days of painful crisis (2.6 vs 4.4), and days of hospitalization (7.1 vs 12.1) compared with placebo56 |
| Dabigatran | Thrombin inhibitor | No human trial has been performed59 |
| Aspirin | Platelet inhibitor via COX-2/prostaglandin | Inconsistent effects on the frequency of VOC92,-94 |
| Piroxicam | Platelet P2Y12 receptor inhibitor | Effective in reducing the mean scores for VOC and mobility without any side effects100 |
| Prasugrel | Platelet P2Y12 receptor inhibitor | This drug inhibited platelet activity in patients, but failed to convincingly reduce VOC95,-97,134 |
| Ticagrelor | Platelet P2Y12 receptor inhibitor | Although the drug reduced platelet activation and was well tolerated in patients, there was no improvement of VOC98 |
| Ticlopidine | Platelet P2Y12 receptor inhibitor | One study showed reduction of platelet activation, but no improvement of VOC99 |
| Another study showed modest reduction of VOC135 | ||
| Eptifibatide | Platelet α2bβ3 inhibitor | The drug was well tolerated in patients in pilot study and reduced CD40L136 |
| But there was no difference in median duration of VOC or opioid use78 |
| Name of drugs . | Mechanism of action . | Outcomes in SCD patients . |
|---|---|---|
| Warfarin, dicumarol | Inhibit coagulation factors thrombin, FVII, FIX, FX, protein C and S through blocking reuse of vitamin K | Warfarin modestly reduced the frequency of VOC (1.3-0.9 per year)57 |
| Acenocoumarol | Long-term administration of dicumarol reduced leg ulcers but did not affect VOC58 | |
| Administration of acenocoumarol for 14 wk showed 3 VOC whereas 5 VOC during placebo133 | ||
| Rivaroxaban | FXa inhibitor | Pending outcome (NCT02072668) |
| Apixaban | FXa inhibitor | Pending outcome (NCT02179177) |
| Heparin | Thrombin inhibitor | Days of hospitalization per year and hours spent in emergency rooms per year were reduced to 73% and 74%, respectively55 |
| Tinzaparin | Thrombin inhibitor | Tinzaparin treatment reduced the number of days with severe pain score (1.3 vs 1.7), overall days of painful crisis (2.6 vs 4.4), and days of hospitalization (7.1 vs 12.1) compared with placebo56 |
| Dabigatran | Thrombin inhibitor | No human trial has been performed59 |
| Aspirin | Platelet inhibitor via COX-2/prostaglandin | Inconsistent effects on the frequency of VOC92,-94 |
| Piroxicam | Platelet P2Y12 receptor inhibitor | Effective in reducing the mean scores for VOC and mobility without any side effects100 |
| Prasugrel | Platelet P2Y12 receptor inhibitor | This drug inhibited platelet activity in patients, but failed to convincingly reduce VOC95,-97,134 |
| Ticagrelor | Platelet P2Y12 receptor inhibitor | Although the drug reduced platelet activation and was well tolerated in patients, there was no improvement of VOC98 |
| Ticlopidine | Platelet P2Y12 receptor inhibitor | One study showed reduction of platelet activation, but no improvement of VOC99 |
| Another study showed modest reduction of VOC135 | ||
| Eptifibatide | Platelet α2bβ3 inhibitor | The drug was well tolerated in patients in pilot study and reduced CD40L136 |
| But there was no difference in median duration of VOC or opioid use78 |