![]() ![]() 1– 3 All-cause mortality is also significantly reduced with DOACs, particularly among patients with nonvalvular atrial fibrillation. Keywords: factor Xa, DOAC, andexanet alfa, reversal, rivaroxaban, apixabanĭirect oral anticoagulants (DOACs) are associated with lower rates of fatal bleeding and death from major bleeding compared to vitamin K antagonists (VKAs). This narrative reviews the development of andexanet alfa and explores its basic science, pharmacokinetics/pharmacodynamics, animal models, and human studies. Andexanet alfa is a FXa decoy designed to reverse all anticoagulants that act through this part of the coagulation cascade including anti-FXa DOACs, such as apixaban, edoxaban and rivaroxaban, and indirect FXa inhibitors such as low-molecular-weight heparins. Unlike the strategy to reverse the only oral direct thrombin inhibitor with idarucizumab, which is a humanized monoclonal antibody fragment, a different approach is necessary to design a single agent that can reverse multiple anti-FXa medications. Although there is an approved reversal agent for the direct thrombin inhibitor dabigatran, a specific reversal agent for the anti-factor Xa (FXa) DOACs has yet to be licensed. Scott Kaatz, 1 Hardik Bhansali, 1 Joseph Gibbs, 2 Robert Lavender, 3 Charles E Mahan, 4 David G Paje 5ġDivision of Hospital Medicine, 2Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, 3Division of General Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 4University of New Mexico, Presbyterian Healthcare Services, Albuquerque, NM, 5Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USAĪbstract: Approximately half of patients started on an oral anticoagulant in the USA now receive one of the newer direct oral anticoagulants (DOACs). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |