Ciraparantag safely and completely reverses the anticoagulant effects of low molecular weight heparin.

Journal Article (Journal Article)

UNLABELLED: Major bleeding with low molecular weight heparin (LMWH) therapy occurs in up to 5% of patients and its anticoagulation is only partially reversed by protamine sulfate. We studied the ability of ciraparantag (PER977), a novel agent that reverses LMWH in preclinical studies, to reverse LMWH in healthy volunteers. METHODS: In this phase 1/2 trial, 4 cohorts of 10 healthy volunteers received escalating doses of ciraparantag (100 to 300mg) or placebo (8:2 ratio) approximately 4h after a single subcutaneous dose of enoxaparin, 1.5mg/kg. Safety, pharmacokinetic and pharmacodynamic effects were assessed. RESULTS: Complete reversal of enoxaparin anticoagulation, measured by a reduction of whole blood clotting time, was observed in all subjects who received a single ciraparantag dose ranging from 100mg to 300mg. The anticoagulation reversal occurred rapidly after bolus injection and persisted for the duration of the study. At 12h and 24h, the differences in whole blood clotting time in the treated group compared to placebo were no longer significant, consistent with the decline in enoxaparin concentrations and anticoagulation effects. No procoagulant signals were detected as measured by D-dimer, F1.2, and tissue factor pathway inhibitor levels. Ciraparantag was well tolerated with only transient, minor side effects. CONCLUSION: Ciraparantag reverses the whole blood clotting time induced by enoxaparin in a dose related manner and produces no procoagulant signal or deleterious adverse events in doses up to 300mg.

Full Text

Duke Authors

Cited Authors

  • Ansell, JE; Laulicht, BE; Bakhru, SH; Hoffman, M; Steiner, SS; Costin, JC

Published Date

  • October 2016

Published In

Volume / Issue

  • 146 /

Start / End Page

  • 113 - 118

PubMed ID

  • 27470323

Electronic International Standard Serial Number (EISSN)

  • 1879-2472

Digital Object Identifier (DOI)

  • 10.1016/j.thromres.2016.07.008


  • eng

Conference Location

  • United States