Idraparinux sodium is an
anticoagulant
Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where the ...
medication in development by
Sanofi-Aventis
Sanofi S.A. is a French multinational pharmaceutical and healthcare company headquartered in Paris, France. Originally, the corporation was established in 1973 and merged with Synthélabo in 1999 to form Sanofi-Synthélabo. In 2004, Sanofi-Syn ...
.
It has a similar chemical structure and the same method of action as
fondaparinux
Fondaparinux (trade name Arixtra) is an anticoagulant medication chemically related to low molecular weight heparins. It is marketed by GlaxoSmithKline. A generic version developed by Alchemia is marketed within the US by Dr. Reddy's Laboratories.
...
, but with an elimination half-life about five to six times longer (an increase from fondaparinux's 17 hours to approximately 80 hours), which means that the drug should only need to be injected once a week.Supriya Dey et al recently reported shortest chemical synthesis of Idraparinux for the large scale production
Sanofi discontinued the development of idraparinux sodium.
Negative clinical trial
A phase III trial of idraparinux sodium for stroke prevention in patients with AF (AMADEUS) was halted prematurely due to excessive clinically relevant and intracranial bleeding. Bleedings were particularly increased in elderly patients and those with renal impairment. Sanofi discontinued the development of idraparinux sodium in favour of a biotinylated formulation of the drug called idrabiotaparinux sodium.
Method of action
Idraparinux selectively blocks
coagulation factor Xa
Factor X, also known by the eponym Stuart–Prower factor, is an enzyme () of the coagulation cascade. It is a serine endopeptidase (protease group S1, PA clan). Factor X is synthesized in the liver and requires vitamin K for its synthesis.
Fac ...
.
See
Heparin: Mechanism of anticoagulant action for a comparison of the mechanism of heparin, low-molecular-weight heparins, fondaparinux and idraparinux.
Idrabiotaparinux
Idrabiotaparinux sodium is also administered once-weekly. It has the same pentasaccharidic structure as idraparinux sodium, but with
biotin
Biotin (or vitamin B7) is one of the B vitamins. It is involved in a wide range of metabolic processes, both in humans and in other organisms, primarily related to the utilization of fats, carbohydrates, and amino acids. The name ''biotin'', bor ...
attached, which allows its neutralisation with
avidin
Avidin is a tetrameric biotin-binding protein produced in the oviducts of birds, reptiles and amphibians and deposited in the whites of their eggs. Dimeric members of the avidin family are also found in some bacteria. In chicken egg white, avidin ...
, an egg-derived protein with low antigenicity.
Sanofi conducted three phase III trials of idrabiotaparinux sodium between 2006 and 2008 in approximately 13,550 patients. In one phase III trial (the BOREALIS-AF study), idrabiotaparinux sodium was non-inferior to warfarin in preventing the recurrent
venous thromboembolism
Venous thrombosis is blockage of a vein caused by a thrombus (blood clot). A common form of venous thrombosis is deep vein thrombosis (DVT), when a blood clot forms in the deep veins. If a thrombus breaks off (embolizes) and flows to the lungs to ...
at three months in patients with pulmonary embolism and the incidence of clinically relevant bleeding was lower in the idrabiotaparinux sodium arm. The drug was expected to be filed for stroke prevention in patients with
atrial fibrillation in 2011. The study was prematurely terminated, and the reason remains unclear. However, Sanofi has since discontinued its development. The company announced in May 2011 that the drug is available for licensing. A systematic review found that until now there is not sufficient evidence to clarify whether idraparinux or idrabiotaparinux are as effective and safe as the standard warfarin treatment for venous thromboembolism prevention. Idraparinux or idrabiotaparinux decreased major bleeding rate significantly but had a trend to increase the all-cause mortality compared with warfarin.
[Song Y, Li X, Pavithra S, Li D (2013) Idraparinux or Idrabiotaparinux for Long-Term Venous Thromboembolism Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS ONE 8(11): e78972]
doi:10.1371/journal.pone.0078972
/ref>
References
{{Antithrombotics
Oligosaccharides
Heparins
8. Supriya Dey, Hong Jay Lo and Chi Huey Wong “ An efficient Modular One pot synthesis of Heparin-Based Anticoagulant Idraparinux” J. Am. Chem. Soc. 2019, 141, 10309