A review with 43 referencesIn recent years, small protein inhibitors of factor Xa have emerged as the initial tools to demonstrate that the prothrombinase complex is a viable alternative target to direct thrombin inhibition.These proteinaceous agents are potent and highly specific inhibitors of factor Xa as well as the prothrombinase complex, and have unambiguously validated the prothrombinase complex as an important in vivo target.However, the potential development of this class of protein-based agents is complex and their therapeutic potential has been traditionally viewed as less desirable compared to the identification of small mol. inhibitors of factor Xa with similar biol. properties.In addition, the identification of orally deliverable anticoagulant therapy continues to be a more attractive target in the development of novel anticoagulants.From these considerations, the last few years have witnessed a growing body of literature describing novel, enzyme-specific, low-mol. weight factor Xa inhibitors that have the potential to be orally effective and to display encouraging therapeutic indexes.Because of these recent developments, a summary of the status of these advances is timely and is the purpose of this review.
