Camonagrel is a novel selective thromboxane synthetase inhibitor patented by Ferrer Internacional S. A. Camonagrel reduced platelet-subendothelium interaction under flow conditions, showing this effect in a range of concentrations lower than in inhibition of platelet aggregation.

Linotroban is a potent and selective thromboxane (TXA2) receptor antagonist. It is known as a novel antithrombotic agent. Linotroban ingestion reduced significantly the thrombus volume. The coagulation, as measured by fibrin deposition and FPA plasma levels, was not significantly affected by Linotroban. It appears that the thromboxane A2 receptor antagonist linotroban reduces the thrombotic response by primarily impairing the platelet function at arterial blood flow conditions, and particularly at high wall shear rates. Linotroban had been in phase II clinical trial for the treatment of thrombosis. But this research was discontinued.

Rivipansel (GMI-1070) is a glycomimetic compound that acts as a pan-selectin inhibitor (binding to E-, P- and L-selectin). It has a 100-fold greater inhibitory acitivity for E-selectin than for P-selectin. In a phase II clinical trial, rivipansel has shown potential to reduce time of resolution for vaso-occlusive crises (although statistically insignificant) and to reduce opioid analgesic use in sickle cell disease patients. Two phase III studies evaluating the efficacy and safety of rivipansel in sickle cell disease patients were still ongoing in 2019. Besides studies in sickle cell disease or related disorders, clinical trials have also evaluated the use of rivipansel in moderate hepatic and renal impairment.

Piridronic acid is pyridinyl bisphosphonate. It is the bone calcium metabolism regulator. Piridronic acid was used for the treatment of osteoporosis. It is the human farnesyl pyrophosphate synthase inhibitor. When expressed on an actual or anticipated clinical dose basis for osteoporosis piridronic acid may have a greater potential for inducing gastric damage than do pyridinyl bisphosphonates. Piridronic acid induced significantly more antral damage than risedronate and a greater number of lesions compared to pamidronate and risedronate.

RO-638695 (also known as Miridesap, CPHPC and GSK-2315698) is an antineoplastic and a serum amyloid P component inhibitor. RO-638695 almost completely depletes circulating serum amyloid P component (SAP), but a small amount of SAP is left for recognition by subsequently administered therapeutic IgG anti-SAP antibodies. SAP is a blood protein that is the target of a novel immunotherapy approach. RO-638695 has therefore been evaluated in phase I and II clinical trials for its safety and potential in treatment of diseases like Alzheimer’s disease, HIV infection and other diseases with systemic amyloid deposition.

Napsagatran [RO 466240], a reversible and highly selective thrombin inhibitor, was in development with Roche for use in myocardial infarction and thrombosis. Napsagatran efficiently inhibits and delays thrombin generation in human coagulating plasma. This reduced thrombin generation might be caused by inhibition of thrombin-mediated feedback reactions during blood coagulation. Ro 46-6240 inhibited clot-bound thrombin three times more potently than fluid-phase thrombin (IC50 19 vs 56 ng/ml) while hirudin was two times (IC50 8 vs 3 ng/ml) and heparin six times (IC50 1,205 vs 200 ng/ml) less active against clot-bound thrombin compared with fluid-phase thrombin.

Letaxaban is an orally active, tetrahydropyrimidin-2(1H)-one derivative and inhibitor of coagulation factor Xa (activated factor X) with anticoagulant activity. Letaxaban may have anti-inflammatory potential in addition to its anti-thrombotic effects. Letaxaban had been in phase II clinical trials by Takeda for the treatment of venous thromboembolism (VTE). However, this research has been discontinued. Takeda had discontinued their phase II clinical trials for the treatment of acute coronary syndrome (ACS) since the results failed to meet the target efficacy and safety profile.

Mitsubishi Tanabe Pharma was developing Sofigatran, a thrombin inhibitor, for the treatment of deep vein thrombosis. Sofigatran, is a direct oral thrombin inhibitor with a competitive binding mechanism. It has been assessed in a phase II trial for the treatment of deep vein thrombosis The compound was in phase II clinical trial for the treatment of DVT. Results of this trial have not been published and the clinical development of sofigatran has been discontinued by Mitsubishi Tanabe Pharma in 2007.