Q; What isidrabiotaparinux? 


Answer:  idrabiotaparinux can be called third generation long acting fondaparinux.

First generation Fondaparinux (arixtra) is the only clinically known low molecular weight Heparin which can be used in Heparin-Induced-Thrombocytopenia (HIT). But on flip side, it has no reversal in case of bleeding except supportive treatment via transfusions.

Second generation fondaparinux is called idraparinux but it quickly lost its charm (actually development)  as it was extremely long acting with dosing once a week without any reversal like parent fondaparinux.

Third generation fondaparinux is called idrabiotaparinux. It is in Phase 3 trials and have advantage of availability of reversal, though it remained once a week dosing. The reversal is via intravenous administration of avidin, which binds to the biotin molecule in the drug. Once a week dosing with availability of reversal may make it a good choice as outpatient treatment  of venous thromboembolism.


References:

1. Equinox Investigators. Efficacy and safety of once weekly subcutaneous idrabiotaparinux in the treatment of patients with symptomatic deep venous thrombosis. J Thromb Haemost 2011; 9:92.

2. Büller HR, Gallus AS, Pillion G, et al. Enoxaparin followed by once-weekly idrabiotaparinux versus enoxaparin plus warfarin for patients with acute symptomatic pulmonary embolism: a randomised, double-blind, double-dummy, non-inferiority trial. Lancet 2012; 379:123.

3.  Paty I, Trellu M, Destors JM, et al. Reversibility of the anti-FXa activity of idrabiotaparinux (biotinylated idraparinux) by intravenous avidin infusion. J Thromb Haemost 2010; 8:722.