Use of thrombin mutants to inhibit the anticoagulation...

A - Human Necessities – 61 – K

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A61K 38/36 (2006.01) A61P 7/04 (2006.01)

Patent

CA 2680736

The present invention provides methods for inhibiting the anticoagulation effect of a thrombin inhibitor in a patient in need thereof comprising administration of a therapeutically effective amount of a variant prothrombin or thrombin that is capable of binding the thrombin inhibitor and that has reduced procoagulant activity. Variant prothrombins or thrombins of use in the methods of the present invention include thrombin mutants W215A, W215A/E217A, or variants thereof in which the amino acids at positions 215 and/or 217 are alanine. Methods are also provided in which the thrombin mutants are administered with an additional active agent, particularly hemostatic agents such as activated factor VII or activated prothrombin complex concentrate. In one embodiment of the invention, the methods are useful in the treatment of patients in which a direct thrombin inhibitor has been administered, particularly argatroban. The present invention further provides a method for quantifying the concentration of an anticoagulant in the plasma or whole blood of a patient using a variant prothrombin or thrombin titration assay.

La présente invention concerne des procédés d'inhibition de l'effet anticoagulant d'un inhibiteur de la thrombine chez un patient qui le nécessite, comprenant l'administration d'une quantité thérapeutiquement efficace d'une prothrombine ou thrombine variante qui est capable de se lier à l'inhibiteur de la thrombine et qui présente une activité procoagulante réduite. Les prothrombines ou thrombines variantes utilisables dans les procédés de la présente invention comprennent les mutants de thrombine W215A, W215A/E217A ou des variants de ceux-ci dans lesquels les acides aminés en position 215 et/ou 217 sont l'alanine. L'invention concerne également des procédés dans lesquels les mutants de thrombine sont administrés avec un autre agent actif, en particulier des agents hémostatiques tels que le facteur VII activé ou un concentré de complexe de prothrombine activée. Dans un mode de réalisation de l'invention, ces procédés sont utiles pour traiter des patients auxquels un inhibiteur direct de la thrombine a été administré, en particulier l'argatroban. L'invention concerne en outre un procédé de quantification de la concentration d'un anticoagulant dans le plasma ou le sang total d'un patient en utilisant un essai de titration de prothrombine ou thrombine variante.

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