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https://www.readbyqxmd.com/read/27697119/-reversal-strategies-for-non-vitamin-k-antagonist-oral-anticoagulants
#1
Frederik Uttenthal Larsen, Anne-Mette Hvas, Erik Lerkevang Grove
Non-vitamin K oral anticoagulants (NOACs) are alternatives to vitamin K antagonists and provide consistent anticoagulation with equal or better clinical outcome and no need for routine monitoring. Bleeding is a feared complication of anticoagulants. Until recently, no specific agent has been available for reversal of NOACs. Idarucizumab binds dabigatran for rapid reversal of its activity without procoagulant effects. Andexanet alpha (expected release in 2016) and PER977 are antidotes under clinical development...
October 3, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27626268/-antidotes-to-novel-direct-oral-anticoagulants
#2
REVIEW
N G Khorev, A P Momot, V O Kon'kova
During the last 10 years, several novel direct oral anticoagulants (NOACs) have entered the clinical arena and were registered in the Russian Federation for use in patients presenting with atrial fibrillation, venous thrombosis, and pulmonary artery thromboembolism. NOACs are classified into two groups: direct thrombin inhibitor (notably dabigatran) and factor Xa inhibitors (including rivaroxaban, apixaban, and edoxaban). Their disadvantage is lack of specific antidotes in case of an emergency situation (injury, infarction, stroke requiring thrombolysis, urgent operation)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27541665/reversal-agents-for-direct-oral-anticoagulants-a-focused-review
#3
REVIEW
Boris Arbit, Marin Nishimura, Jonathan C Hsu
For several decades the vitamin K antagonist oral anticoagulants were the only outpatient therapy that existed to reduce the risk of stroke and thromboembolism. When the new direct oral anticoagulants were approved for use and addressed many of the issues associated with oral vitamin K antagonists, a new concern arose-the lack of rapid ability to reverse these agents. Physicians and patients were concerned that in cases of life-threatening bleeding or need for emergent surgery, an antidote to reverse the anticoagulation effect of these agents did not exist...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27402803/direct-oral-anticoagulants-unique-properties-and-practical-approaches-to-management
#4
REVIEW
Geoffrey D Barnes, Brian Kurtz
Since 2009, four direct oral anticoagulants (DOACs) have been introduced for treatment of venous thromboembolism and stroke prevention in non-valvular atrial fibrillation. While they are currently first-line therapy for a majority of patients, there are a number of clinical situations where warfarin is preferable. In both randomised trials and real-world populations, use of DOACs significantly reduces the risk of intracranial haemorrhage as compared with warfarin. While drug-specific reversal agents are currently only available for dabigatran, andexanet alpha is pending approval for reversal of factor Xa inhibitors, reducing concerns about major bleeding for many patients and providers...
October 15, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27297642/-direct-oral-anticoagulant-associated-bleeding
#5
REVIEW
A Godier, A-C Martin, N Rosencher, S Susen
Direct oral anticoagulants (DOAC) are recommended for stroke prevention in atrial fibrillation and for the treatment of venous thromboembolism. However, they are associated with hemorrhagic complications. Management of DOAC-induced bleeding remains challenging. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. Therapeutic options also include antidotes: idarucizumab, antidote for dabigatran, has been approved for use whereas andexanet alpha, antidote for anti-Xa agents, and aripazine, antidote for all DOAC, are under development...
July 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/26380149/novel-antidotes-for-target-specific-oral-anticoagulants
#6
REVIEW
Arundhati Das, Delong Liu
Target specific oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban) are changing the landscape of anticoagulation. The major drawback is the absence of an effective antidote for severe bleedings and/or prior to procedures. Currently there are a few promising antidotes undergoing clinical trials. This review summarized the latest development in idarucizumab, andexanet alpha and PER977.
2015: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/25832311/reversal-of-anticoagulants-an-overview-of-current-developments
#7
REVIEW
Andreas Greinacher, Thomas Thiele, Kathleen Selleng
Several new anticoagulants have entered the clinical arena or are under clinical development. These drugs include indirect (fondaparinux) and direct oral factor Xa inhibitors (rivaroxaban, apixaban, edoxaban, betrixaban), and the direct thrombin inhibitor dabigatran. Especially the oral direct FXa and FIIa inhibitors overcome many of the shortcomings of heparins and vitamin K antagonists (VKAs). They are administered orally at a fixed dose; regular monitoring is not necessary; interaction with other drugs or nutrition occur less than with VKAs and they are at least as effective as VKAs for most indications tested...
May 2015: Thrombosis and Haemostasis
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