Pharmacokinetics and pharmacodynamics of the dual FII/FX inhibitor BIBT 986 in endotoxin-induced coagulation

• Published in: Clinical pharmacology and therapeutics Vol. 81; no. 6; p. 858
• Main Authors: Leitner, J M, Jilma, B, Mayr, F B, Cardona, F, Spiel, A O, Firbas, C, Rathgen, K, Stähle, H, Schühly, U, Graefe-Mody, E U
• Format: Journal Article
• Language: English
• Published: United States 01.06.2007
• Subjects: Adolescent; Adult; Area Under Curve; Blood Coagulation - drug effects; Dose-Response Relationship, Drug; Double-Blind Method; Endotoxemia - blood; Endotoxemia - drug therapy; Factor Xa Inhibitors; Fibrinolytic Agents - pharmacokinetics; Fibrinolytic Agents - pharmacology; Half-Life; History, 15th Century; Humans; Inflammation - blood; Lipopolysaccharides; Male; Metabolic Clearance Rate; Partial Thromboplastin Time; Platelet Activation - drug effects; Prospective Studies; Prothrombin - antagonists & inhibitors
• ISSN: 0009-9236
• DOI: 10.1038/sj.clpt.6100153

BIBT986 is a dual inhibitor of factors Xa and IIa. The aim of this study was to compare with placebo the effect of three doses of BIBT986 on coagulation, platelet activation, and inflammation. This was a prospective, randomized, double-blind, placebo-controlled, parallel-group dose escalation trial in 48 healthy male volunteers. Participants received one of three doses of BIBT986 or placebo intravenously together with a bolus infusion of 2 ng/kg lipopolysaccharide (LPS). BIBT986 dose-dependently changed global coagulation parameters and in vivo markers of thrombin generation and action: BIBT986 doses, which prolonged activated partial thromboplastin time by 100%, completely suppressed the LPS-induced increases in prothrombin fragment, thrombin-antithrombin complexes, and D-dimer, which were 6.1-, 14.5, and 3.5-fold in the placebo group, respectively. BIBT986 did not influence inflammation, fibrinolysis, or platelet activation. Therefore, BIBT986 is a potent anticoagulant in the human endotoxemia model.