Potential Therapeutic Roles for Direct Factor Xa Inhibitors in Coronavirus Infections.

Rami A Al-Horani

American journal of cardiovascular drugs : drugs, devices, and other interventions 2020 Dec

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Human factor Xa (FXa) is a serine protease of the common coagulation pathway. FXa is known to activate prothrombin to thrombin, which eventually leads to the formation of cross-linked blood clots. While this process is important in maintaining hemostasis, excessive thrombin generation results in a host of thrombotic conditions. FXa has also been linked to inflammation via protease-activated receptors. Together, coagulopathy and inflammation have been implicated in the pathogenesis of viral infections, including the current coronavirus pandemic. Direct FXa inhibitors have been shown to possess anti-inflammatory and antiviral effects, in addition to their established anticoagulant activity. This review summarizes the pharmacological activities of direct FXa inhibitors, their pharmacokinetics, potential drug-drug interactions and adverse effects, and the details of clinical trials involving direct FXa inhibitors in coronavirus disease 2019 (COVID-19) patients.

Citation

Rami A Al-Horani. Potential Therapeutic Roles for Direct Factor Xa Inhibitors in Coronavirus Infections. American journal of cardiovascular drugs : drugs, devices, and other interventions. 2020 Dec;20(6):525-533