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Idarucizumab

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https://www.readbyqxmd.com/read/29766734/-more-safe-anticoagulant-treatment-use-of-idarucizumab-praxbind%C3%A2-case-reports-from-re-verse-ad-study-and-clinical-practice
#1
David Tuček, Tomáš Veleta, Martin Havrda
RE-VERSE AD, a prospective multicentric cohort study, examined the effect of idarucizumab on 2 cohorts of patients anticoagulated with dabigatran - in cohort A in patients with uncontrollable or life threatening bleeding, in cohort B in patients who undergo acute surgery. Within the study patients were intravenously administered 5 g antidote divided into 2 doses per 2.5 g within 15 min to eliminate the anticoagulation effect of dabigatran. A series of case studies is presented to describe the use of idarucizumab within the RE-VERSE AD study and in clinical practice in the period of 2015-2016 at the University Hospital Hradec Králové...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29740732/successful-treatment-with-idarucizumab-for-diffuse-alveolar-hemorrhage-induced-by-dabigatran-etexilate-a-case-report
#2
Akihiro Shiroshita, Kei Nakashima, Yu Tanaka, Akiko Tateishi, Masahiro Nemoto, Masahiro Aoshima
We report the case of an 81-year-old man taking dabigatran etexilate (dabigatran) for chronic atrial fibrillation, who presented with acute-onset hemoptysis and hypoxia. Chest high-resolution computed tomography showed bilateral ground grass opacities. After admission, his respiratory failure progressed rapidly and bronchoalveolar lavage was performed immediately, which showed copious amounts of bloody fluid and hemosiderin-laden macrophages with Prussian blue staining. He was diagnosed as having diffuse alveolar hemorrhage (DAH)...
May 8, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29729372/management-of-bleeding-and-emergency-invasive-procedures-in-patients-on-dabigatran-updated-guidelines-from-the-french-working-group-on-perioperative-haemostasis-gihp-september-2016
#3
Pierre Albaladejo, Gilles Pernod, Anne Godier, Emmanuel de Maistre, Nadia Rosencher, Jean Louis Mas, Pierre Fontana, Charles Marc Samama, Annick Steib, Sylvie Schlumberger, Emmanuel Marret, Stéphanie Roullet, Sophie Susen, Samia Madi-Jebara, Philippe Nguyen, Jean François Schved, Fanny Bonhomme, Pierre Sié
In 2013, the GIHP published guidelines for the management of severe haemorrhages and emergency surgery. This update applies to patients treated with dabigatran, with a bleeding complication or undergoing an urgent invasive procedure. It includes how to handle the available specific antidote (idarucizumab), when to measure dabigatran plasmatic concentration, and when to use non-specific measures in these situations. It also includes guidelines on how to perform regional anaesthesia and analgesia procedures.
May 2, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29703468/antidotes-for-the-direct-oral-anticoagulants-what-news
#4
S Galliazzo, M P Donadini, W Ageno
The direct oral anticoagulants (DOACs) are recommended as the first-choice anticoagulants for both stroke prevention in patients with non-valvular atrial fibrillation and the treatment and secondary prevention of venous thromboembolism. DOACs cause bleeding, albeit less than warfarin. Most bleeding complications can be controlled by general reversal strategies and supportive care. However, in case of life-threatening bleeding, or when urgent invasive procedures are needed, a more rapid and thorough reversal may be required...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29687299/anticoagulation-reversal-in-vitamin-k-antagonist-associated-intracerebral-hemorrhage-a-systematic-review
#5
Darae Ko, Zayd Razouki, James Otis, Erika Marulanda-Londoño, Elaine M Hylek
The effect of rapid anticoagulation reversal on mortality and functional outcome in vitamin K antagonist-associated intracerebral hemorrhage (VKA-ICH) is uncertain. Given the approval of idarucizumab for dabigatran reversal and pending approval for andexanet alfa for reversal of factor Xa inhibitors, a systematic appraisal of the effectiveness of reversal for VKA-ICH would provide a bench mark for current practice. We performed PubMed searches and reviewed current guidelines. Using pre-specified inclusion and exclusion criteria, studies were reviewed by two physicians independently...
April 23, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29661415/reversal-of-dabigatran-by-intraosseous-or-intravenous-idarucizumab-in-a-porcine-polytrauma-model
#6
N Akman, T Braunschweig, M Honickel, K Schütt, H Schöchl, C Stoppe, R Rossaint, O Grottke
BACKGROUND: Idarucizumab is licensed to reverse dabigatran in life-threatening haemorrhage. Establishment of venous access can be challenging, and the intraosseous (IO) route is a potentially life-saving alternative. In this study, we compared the efficacy and safety of IO or intravenous (i.v.) idarucizumab for dabigatran reversal in a porcine polytrauma model. METHODS: Male pigs (n=21) received oral dabigatran etexilate (30 mg kg-1 bid) for 3 days. On the 4th day, animals received dabigatran infusion and were randomised 1:1:1 to receive IO saline (control), i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29644298/use-of-idarucizumab-for-dabigatran-reversal-emergency-department-experience-in-two-cases-with-subdural-haematoma
#7
Gail Edwards, Cristina Roman, Rondhir Jithoo, Biswadev Mitra
Introduction: Idarucizumab is the first effective humanized monoclonal antibody fragment developed specifically as a reversal agent for dabigatran, a Direct Oral Anticoagulant. Despite recent trials demonstrating reversal of clinically relevant bleeding, there is a paucity of data on use outside the trial setting. This manuscript describes the use of Idarucizumab to reverse dabigatran in two patients presenting to the emergency department of a major tertiary hospital with acute traumatic subdural haematomas (SDH)...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29622761/simultaneous-pancreas-kidney-transplantation-in-a-patient-with-heparin-induced-thrombocytopenia-on-dabigatran-therapy
#8
Agnieszka Jóźwik, Wojciech Lisik, Jarosław Czerwiński, Maciej Kosieradzki
BACKGROUND New oral anticoagulants like direct thrombin inhibitors are an attractive alternative to vitamin K antagonists as anticoagulation therapy and can be used in heparin-induced thrombocytopenia. They are convenient in low-risk surgery, as there is no need for bridging with heparins. Patients who need urgent major surgery are at similar risk as on warfarin therapy, which, however, is much higher than in elective procedures. Due to their elimination profiles, these drugs are generally contraindicated in patients with severe renal insufficiency...
April 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29573340/the-adsorption-of-dabigatran-is-as-efficient-as-addition-of-idarucizumab-to-neutralize-the-drug-in-routine-coagulation-assays
#9
M Jacquemin, J Toelen, L Feyen, J Schoeters, I Van Horenbeeck, I Vanlinthout, M Debasse, T Vanassche, K Peerlinck, P Verhamme
INTRODUCTION: The direct thrombin inhibitor dabigatran interferes with thrombophilia screening and with the diagnosis of hemostasis disorders that develop during treatment with the anticoagulant. In vitro addition of idarucizumab, a humanized antibody fragment that binds dabigatran, to plasma samples containing dabigatran fully neutralizes the drug. This study was carried out to determine whether binding of dabigatran on selected insoluble commercial adsorbent material, DOAC-STOPR , was as efficient as idarucizumab to neutralize the anticoagulant activity of the drug in vitro...
March 24, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29569500/mechanisms-of-action-and-clinical-use-of-specific-reversal-agents-for-non-vitamin-k-antagonist-oral-anticoagulants
#10
Kristoffer Andresen, Dan Atar, Erik Gjertsen, Waleed Ghanima, Svein Roseth, Odd Erik Johansen
OBJECTIVES: With a steadily growing number of patients with non-valvular atrial fibrillation, anticoagulation use increases. Anticoagulation therapy is associated with increased risk of serious bleeding and an increased complexity in management of patients in need for urgent surgery. We wanted to assess the magnitude of this challenge as well as review current and potential future clinical management strategies. DESIGN: A review of the literature on the magnitude of patients using antigoaculants in potential need for acute restoration of hemostasis was conducted, as well as current status of reversal agents for non-vitamin K antagonist oral anticoagulants (NOACs)...
March 23, 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29555397/thrombolytic-therapy-in-severe-cardioembolic-stroke-after-reversal-of-dabigatran-with-idarucizumab-case-report-and-literature-review
#11
Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29536479/repeated-administration-of-idarucizumab-to-a-patient-with-dabigatran-overdose
#12
Zdeňka Hajšmanová, Pavla Šigutová, Alena Lavičková
Idarucizumab is designed to reverse the anticoagulant effect of dabigatran. This case report describes the administration of three independent doses of idarucizumab to a 76-year-old man suffering from atrial flutter being treated with dabigatran to prevent ischaemic stroke. The last dose of dabigatran was administered in the morning of the same day the patient was transferred to hospital because of the need for urgent pericardium puncture. Baseline dTT (dilute thrombin time) reached 700 ng/mL as glomerular filtration (GF) dropped to 0...
February 2018: Hämostaseologie
https://www.readbyqxmd.com/read/29534609/the-renal-elimination-pathways-of-the-dabigatran-reversal-agent-idarucizumab-and-its-impact-on-dabigatran-elimination
#13
Stephan Glund, Guanfa Gan, Viktoria Moschetti, Paul Reilly, Markus Honickel, Oliver Grottke, Joanne Van Ryn
Idarucizumab, a humanized monoclonal antibody fragment (Fab), provides rapid and sustained reversal of dabigatran-mediated anticoagulation. Idarucizumab and dabigatran are mainly eliminated via the kidneys. This analysis aimed to characterize the renal elimination of idarucizumab and investigate the influence of idarucizumab on the pharmacokinetics (PK) of dabigatran and vice versa. Studies were conducted in 5/6 nephrectomized rats, in human volunteers with and without renal impairment, and in a porcine liver trauma model...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29496373/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2017
#14
REVIEW
Drayton A Hammond, Laura Baumgartner, Craig Cooper, Elisabeth Donahey, Serena A Harris, Jessica M Mercer, Mandy Morris, Mona K Patel, Angela M Plewa-Rusiecki, Alia A Poore, Ryan Szaniawski, Deanna Horner
PURPOSE: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29494368/pharmacologic-reversal-of-direct-oral-anticoagulants
#15
Nicholas Farina, James T Miller
Direct oral anticoagulants are becoming increasingly popular in outpatient use. These medications have lacked specific reversal agents. However, this is changing. The Federal Food and Drug Administration approved idarucizumab for reversal of dabigatran in 2016, and another agent, andexanet alfa, is currently in clinical trials for reversal of rivaroxaban and apixaban. This article examines the efficacy and safety of these emerging reversal agents, as well as other historical agents for reversal of direct oral anticoagulants...
April 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29493031/review-an-overview-and-analysis-of-novel-oral-anticoagulants-and-their-dental-implications
#16
REVIEW
Kevin Fortier, Deepti Shroff, Uday N Reebye
BACKGROUND: Dabigatran, rivaroxaban, apixaban and edoxaban are approved novel oral anticoagulants (NOACs) as alternatives to Vitamin K antagonists (VKA). Physicians are prescribing an ever-increasing amount these drugs to their patients due to various advantages over existing medications. AIMS: The objective of this review is to provide the dental professional with current literature surrounding the emergence of NOACs, as well as various case studies on the subject, in an effort to guide clinical decision making regarding these medications...
June 2018: Gerodontology
https://www.readbyqxmd.com/read/29456085/what-is-the-role-of-reversal-agents-in-the-management-of-emergency-department-patients-with-dabigatran-associated-hemorrhage
#17
Bryan D Hayes, Michael E Winters, Steve B Rosenbaum, Mohannad F Allehyani, Gary M Vilke
BACKGROUND: In 2010, the U.S. Food and Drug Administration (FDA) approved dabigatran as the first non-warfarin oral anticoagulant for use in the United States. At the time of FDA approval, there was no antidote or effective treatment for dabigatran-induced hemorrhage. In 2015, the FDA approved idarucizumab for the treatment of dabigatran-induced hemorrhage. The purpose of this clinical practice statement is to evaluate the role of select reversal agents in the management of patients with dabigatran-associated bleeding...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29425981/spontaneous-cervical-spinal-epidural-hematoma-associated-with-dabigatran
#18
Quentin Mathais, Pierre Esnault, Maximilien Cruc, Cedric Bernard, Bertrand Prunet, Pierre Emmanuel Gaillard
BACKGROUND: While spontaneous spinal epidural hematomas are rare, 1 of the identified risk factors is vitamin K antagonist therapy. CASE DESCRIPTION: We present a case of a spontaneous spinal epidural hematoma occurring in a patient under treatment with dabigatran, a non-vitamin K oral anticoagulant. The initial hemiparesis symptom was misleading and was retrospectively identified as Brown-Séquard syndrome. Immediate dabigatran antagonism with idarucizumab followed by posterior cervical laminectomy permitted a complete neurologic recovery at day 4...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29424347/intravenous-stroke-thrombolysis-after-reversal-of-dabigatran-effect-by-idarucizumab-first-reported-case-in-hong-kong
#19
W T Lo, K F Ng, S Ch Chan, V Wy Kwok, C S Fong, S T Chan, G Ck Wong, W C Fong
No abstract text is available yet for this article.
February 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29368938/severe-obscure-gastrointestinal-bleeding-successfully-treated-with-idarucizumab
#20
Enrique Rodríguez de Santiago, María Sierra Morales, Javier Martínez González
Idarucizumab is a monoclonal antibody that rapidly reverses the anticoagulant effect of dabigatran. The experience with this drug in the setting of gastrointestinal bleeding is scarce. We present the case of an 84-year-old male with known history of non-valvular atrial fibrillation anticoagulated with dabigatran who presented to the emergency room with melena. During his stay in the emergency department he suddenly worsened with hemodynamic derangement and massive melena so idarucizumab was administered. Gastroscopy and colonoscopy were performed without identifying a bleeding source...
January 25, 2018: Revista Española de Enfermedades Digestivas
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