Reversing targeted oral anticoagulants.

Journal Article (Journal Article;Review)

Dabigatran, rivaroxaban, and apixaban are orally active anticoagulants that are approved in many countries. Dabigatran inhibits thrombin, whereas rivaroxaban and apixaban are factor Xa inhibitors. In clinical trials, these novel oral anticoagulants were at least as effective as warfarin for preventing stroke in patients with atrial fibrillation, but with a lower rate of serious bleeding. However, the lack of true antidotes for these agents has caused concern when patients suffer life-threatening bleeding or trauma or require emergent invasive procedures. True antidotes are under development for all of these agents. In the meantime, activated and nonactivated prothrombin complex concentrates have been used as reversal agents. Factor VIIa may also be effective for reversal of the factor Xa inhibitors. Reversal of novel oral anticoagulants by these hemostatic agents has not been studied in bleeding human patients, so their true efficacy and appropriate dosing are not known.

Full Text

Duke Authors

Cited Authors

  • Hoffman, M; Monroe, DM

Published Date

  • December 5, 2014

Published In

Volume / Issue

  • 2014 / 1

Start / End Page

  • 518 - 523

PubMed ID

  • 25696904

Electronic International Standard Serial Number (EISSN)

  • 1520-4383

Digital Object Identifier (DOI)

  • 10.1182/asheducation-2014.1.518

Language

  • eng

Conference Location

  • United States