Journal
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
Volume 2, Issue 2, Pages 251-265Publisher
WILEY
DOI: 10.1002/rth2.12089
Keywords
andexanet; ciraparantag; direct oral anticoaglants; FEIBA; idarucizumab; prothrombin complex concentrate; recombinant factor VIIa; reversal
Categories
Funding
- Hamilton Health Sciences Foundation
- Heart and Stroke Foundation of Canada
Ask authors/readers for more resources
The direct oral anticoagulants (DOACs) are used for stroke prevention in atrial fibrillation (SPAF) and the prevention and treatment of venous thromboembolic disease (VTE). Although DOAC-associated bleeding events are less frequent as compared to vitamin K antagonists, there is significant concern surrounding physicians' ability to evaluate and manage DOAC--associated bleeding when it does occur. Idarucizumab is a specific reversal agent for dabigatran and is the agent of choice for dabigatran reversal in the setting of major bleeding or urgent surgery/procedures. There are no commercially available specific reversal agents for the direct Xa inhibitors. Although they have not been rigorously studied in DOAC--treated patients requiring urgent anticoagulant reversal, limited evidence from in vitro studies, animal bleeding models, human volunteer studies (in vivo and in vitro) and case series suggest that coagulation factor replacement with prothrombin complex concentrate (PCC) and activated PCC (FEIBA) may contribute to hemostasis. However, the safety and efficacy of these agents and the optimal dosing strategies remain uncertain.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available