Inhibition of Factor XI: A New Era in the Treatment of Venous Thromboembolism in Cancer Patients?

Direct oral anticoagulants against activated factor X and thrombin were the last milestone in thrombosis treatment. Step by step, they replaced antivitamin K and heparins in most of their therapeutic indications. As effective as the previous anticoagulant, the decreased but persistent risk of bleeding while using direct oral anticoagulants has created space for new therapeutics aiming to provide the same efficacy with better safety.

Screening cancer after venous thromboembolism: How many abnormal tests before diagnosing cancer? An analysis of practice.

Introduction: Since Trousseau, we knows that venous thrombemboembolism (VTE) can reveal occult cancer. Different strategies of cancer screening have been evaluated: they are often time-consuming, cause stress and anxiety, and frequently require second-look examinations (due to the risk of false positives), with ultimately a very low yield (about 5%). We evaluated the number of suspect cancer tests before reporting them to the number of cancers finally diagnosed, after a VTE, in the setting of practice's analysis.

[Management of superficial vein thrombosis].

Recent epidemiological studies have highlighted the potential severity of superficial vein thrombosis of the lower limbs (SVT). Diagnosis is based on clinical and Doppler ultrasonography evaluation, and define its therapeutic management. If SVT is associated with objectively confirmed deep vein thrombosis or pulmonary embolism, curative anticoagulation is indicated.

[New oral anticoagulants in the treatment of venous thromboembolism].

Rivaroxaban (with initial increased dosage) may be used as a stand-alone therapy in patients with venous thrombo-embolism. The development of new anticoagulant drugs opened several options in the management of venous thrombo-embolism. The efficacy and safety of these new oral anticoagulants in specific population as elderly and those with renal impairment deserve future research.

[Epidemiologic and therapeutic advances in superficial venous thrombosis of the legs].

Thromboses affecting venous superficial system have been considered as benign diseases. Recent studies demonstrate that they might be associated with more severe venous events (as deep venous thrombosis [DVT] or pulmonary embolism [PE]), initially or during 3-month followup. The POST study presents clinical evolution of 844 patients with superficial venous thrombosis (SVT) of lower limbs.

Recent findings in the epidemiology, diagnosis and treatment of superficial-vein thrombosis.

Recent data on lower-limb superficial-vein thrombosis (SVT) may substantially impact its clinical management. Thus, the clear confirmation that SVT is closely linked to deep-vein thrombosis (DVT) or pulmonary embolism (PE) highlights the potential severity of the disease. DVT or PE are diagnosed in 20-30% of SVT patients.

Thrombophilia and risk of venous thrombosis in patients with cancer.

Venous thrombosis is a common and severe complication in patients with cancer. We reviewed studies assessing whether a state of acquired or congenital thrombophilia influenced the risk of thrombosis in patients with cancer. The results are equivocal.

Splice variant-specific stabilization of JNKs by IB1/JIP1.

Islet-Brain 1 (IB1) (also called JNK-interacting protein 1; JIP1) is a scaffold protein that tethers components of the JNK mitogen-activated protein kinase pathway inducing a modulation of the activity and the target specificity of the JNK kinases. Dysfunctions in IB1 have been associated with diseases such as early type II diabetes. To gain more insight in the functions of IB1, its ability to modulate the expression levels of the various JNK proteins was assessed.

[Initial treatment of venous thromboembolic events].

Initial treatment of venous thromboembolic events is currently based on antithrombotics. This treatment is validated and identical for deep vein thrombosis (DVT) and pulmonary embolism. For distal DVT, this treatment has still to be validated.

Intravenous thrombolytic therapy in patients with phlegmasia caerulea dolens.

In a prospective study, nine patients with phlegmasia caerulea dolens (PCD) related to iliac occlusive thrombosis were treated with intravenous thrombolysis. After thrombolysis, despite no significant improvement in the Marder score value, progression to venous gangrene, major hemorrhage or death was not observed and no amputation was needed. Intravenous thrombolysis should be seriously considered in patients with PCD.

Clinical efficacy and safety of fondaparinux in the prevention and treatment of venous and arterial thrombosis.

Fondaparinux (Arixtra) is a synthetic, selective Factor Xa inhibitor. Its pharmacokinetic profile allows once-daily subcutaneous administration of the drug without any laboratory monitoring. The benefit-to-risk ratio of fondaparinux in the prevention of venous thromboembolism has been extensively studied in both surgical and acutely ill medical patients at risk of thrombosis.

Islet-brain (IB)/JNK-interacting proteins (JIPs): future targets for the treatment of neurodegenerative diseases?

Islet-Brain (IB) proteins [also called JNK-interacting proteins (JIPs)] are scaffold proteins that are mainly expressed in the pancreatic islets and in the brain. Functionally, the IB family is composed of IB1, IB2, IB3, and IB4 each with distinct splice variants. The IB family of proteins regulates several mitogen-activated protein kinase (MAPK) pathways by tethering their components and modifying the spectrum of substrates targeted by the MAPKs.