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International Journal of Molecular Sciences
Article . 2020 . Peer-reviewed
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Other literature type . 2020
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The Interactions of Nintedanib and Oral Anticoagulants—Molecular Mechanisms and Clinical Implications

Authors: Grzegorz Grześk; Anita Woźniak-Wiśniewska; Jan Błażejewski; Bartosz Górny; Łukasz Wołowiec; Daniel Rogowicz; Alicja Nowaczyk;

The Interactions of Nintedanib and Oral Anticoagulants—Molecular Mechanisms and Clinical Implications

Abstract

Nintedanib is a synthetic orally active tyrosine kinase inhibitor, whose main action is to inhibit the receptors of the platelet-derived growth factor, fibroblast growth factor and vascular endothelial growth factor families. The drug also affects other kinases, including Src, Flt-3, LCK, LYN. Nintedanib is used in the treatment of idiopathic pulmonary fibrosis, chronic fibrosing interstitial lung diseases and lung cancer. The mechanism of action suggests that nintedanib should be considered one of the potential agents for inhibiting and revising the fibrosis process related to COVID-19 infections. Due to the known induction of coagulation pathways during COVID-19 infections, possible interaction between nintedanib and anticoagulant seems to be an extremely important issue. In theory, nintedanib could increase the bleeding risk, thrombosis and lead to thrombocytopenia. The data from clinical trials on the concomitant use of nintedanib and antithrombotic agents is very limited as this patient group was within the standard exclusion criteria. Nintedanib is an important therapeutic option, despite its interaction with anticoagulants. If anticoagulant therapy is necessary, the more effective and safer option is the concomitant administration of DOACs and nintedanib, especially when drug-monitored therapy will be used in patients at high risk of bleeding complications.

Keywords

Indoles, Lung Neoplasms, Antidotes, Anticoagulants, COVID-19, Antineoplastic Agents, Hemorrhage, Review, Blood Coagulation Disorders, Idiopathic Pulmonary Fibrosis, COVID-19 Drug Treatment, Risk Factors, Humans, Drug Interactions, Protein Kinase Inhibitors

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    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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    influence
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
31
Top 10%
Top 10%
Top 10%
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gold