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Idarucizumab case report

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https://www.readbyqxmd.com/read/27844035/intravenous-thrombolysis-in-acute-ischemic-stroke-after-dabigatran-reversal-with-idarucizumab-a-case-report
#1
Johannes Sebastian Mutzenbach, Slaven Pikija, Ferdinand Otto, Ursula Halwachs, Friedrich Weymayr, Johann Sellner
Much excitement has been generated with the approval of idarucizumab, a humanized monoclonal antigen-binding antibody fragment that is capable of reversing the anticoagulant activity of dabigatran. Here, we describe our initial experience of using tissue plasminogen activator (tPA) in an acute posterior circulation ischemic stroke after dabigatran reversal with idarucizumab. Both treatments were well tolerated and no hemorrhagic or procoagulatory complications were observed. We propose that the option of dabigatran reversal needs to be considered for contemporary treatment concepts of acute ischemic stroke...
November 2016: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/27836320/emergency-lumbar-puncture-in-a-patient-receiving-dabigatran-after-antagonization-with-idarucizumab-a-case-report
#2
Tim Bastian Braemswig, Christoph C Eschenfelder, Christian H Nolte
Idarucizumab is an antibody fragment which is used to reverse the anticoagulant effects of dabigatran. We report on the first successful use of idarucizumab before performing an emergency lumbar puncture in a patient on effective anticoagulation with dabigatran thought to have infective cerebral disease (such as temporal encephalitis).
October 29, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27797449/idarucizumab-for-reversal-of-dabigatran-prior-to-acute-surgery-a-schematic-approach-based-on-a-case-report
#3
Lene Rosenberg, Gustav Gerstrøm, Mads Nybo
Dabigatran, an oral direct thrombin inhibitor, is frequently used in treatment of venous thromboembolism and prevention of stroke in non-valvular atrial fibrillation. Recently, idarucizumab, a monoclonal antibody fragment that reverses the dabigatran effect, was introduced to the market to be used in case of life-threatening bleeding or acute surgery/invasive procedures. Whether usage should be guided by measurement of plasma dabigatran and/or other coagulation parameters is, however, still uncertain. We here describe the use of idarucizumab prior to acute surgery in a patient on dabigatran and acetylsalicylic acid...
October 31, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27737559/answer-by-the-authors-to-the-letter-of-dr-wang-and-colleagues-concerning-our-case-report-entitled-idarucizumab-for-dabigatran-overdose
#4
Marijke Peetermans, Peter Verhamme
No abstract text is available yet for this article.
October 14, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27686252/successful-thrombolysis-with-recombinant-tissue-plasminogen-activator-after-antagonizing-dabigatran-by-idarucizumab-a-case-report
#5
Annemarie Gawehn, Yassine Ayari, Christian Heuschkel, Matthias Kaste, Pawel Kermer
BACKGROUND: Effective anticoagulation routinely precludes patients from receiving intravenous thrombolysis with recombinant tissue plasminogen activator to reverse severe symptoms of ischemic stroke. We report what we believe to be the first case of ischemic stroke successfully treated with recombinant tissue plasminogen activator after antagonizing dabigatran with the monoclonal antibody idarucizumab, recently approved worldwide. CASE PRESENTATION: A 75-year-old Caucasian man presented to our hospital with severe aphasia and mild hemiparesis...
September 29, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27669031/reversal-of-anticoagulation-with-dabigatran-in-an-82-year-old-patient-with-traumatic-retroperitoneal-arterial-bleeding-using-the-new-antidote-idarucizumab-a-case-report
#6
Stefan Hofer, Christoph Philipsenburg, Markus A Weigand, Thorsten Brenner
Dabigatran etexilate is a direct oral anticoagulant used for the prevention of stroke in atrial fibrillation. Idarucizumab is a recently approved specific antidote that reverses the effect of dabigatran within minutes. We report the case of an 82-year-old patient with traumatic retroperitoneal arterial bleeding under anticoagulation with dabigatran etexilate. By administration of idarucizumab, we successfully normalized coagulation and saved the patient from an operation. In the course of the disease, a slight reincrease in dabigatran etexilate plasma levels was observed 2 days after the reversal, which could lead to a new onset of bleeding...
December 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27581709/management-of-dabigatran-associated-bleeding-with-two-doses-of-idarucizumab-plus-hemodialysis
#7
Kaylee K Marino, Raul A Santiago, Richard B Dew, Nancy Berliner, Jean M Connors, Nathan T Connell, John Kevin Tucker
Vitamin K antagonists have been a mainstay of treatment for patients requiring anticoagulation for atrial fibrillation, but direct oral anticoagulants, such as dabigatran, have become increasingly prescribed. Compared with warfarin, dabigatran has a significantly lower risk of life-threatening bleeding; however, bleeding events can still occur, supporting the need for effective reversal strategies. Idarucizumab was recently approved by the U.S. Food and Drug Administration to reverse the anticoagulant effects of dabigatran when life-threatening bleeding occurs or an urgent need for an invasive medical procedure exists...
October 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27488232/managing-reversal-of-direct-oral-anticoagulants-in-emergency-situations-anticoagulation-education-task-force-white-paper
#8
Walter Ageno, Harry R Büller, Anna Falanga, Werner Hacke, Jeroen Hendriks, Trudie Lobban, Jose Merino, Ivan S Milojevic, Francisco Moya, H Bart van der Worp, Gary Randall, Konstantinos Tsioufis, Peter Verhamme, A John Camm
Anticoagulation is the cornerstone of prevention and treatment of venous thromboembolism (VTE) and stroke prevention in patients with atrial fibrillation (AF). However, the mechanisms by which anticoagulants confer therapeutic benefit also increase the risk of bleeding. As such, reversal strategies are critical. Until recently, the direct oral anticoagulants (DOACs) dabigatran, rivaroxaban, apixaban, and edoxaban lacked a specific reversal agent. This report is based on findings from the Anticoagulation Education Task Force, which brought together patient groups and professionals representing different medical specialties with an interest in patient safety and expertise in AF, VTE, stroke, anticoagulation, and reversal agents, to discuss the current status of anticoagulation reversal and fundamental changes in management of bleeding associated with DOACs occasioned by the approval of idarucizumab, a specific reversal agent for dabigatran, as well as recent clinical data on specific reversal agents for factor Xa inhibitors...
November 30, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27313909/use-of-continuous-renal-replacement-therapy-for-removal-of-dabigatran-in-a-patient-in-need-of-emergent-surgery
#9
Sara E Parli, Melissa L Thompson Bastin, Daniel A Lewis
Purpose. To report the ability to remove serum dabigatran using continuous renal replacement therapy (CRRT) in a patient with life-threatening bleeding. Summary. A 77-year-old female with history of atrial fibrillation who takes dabigatran for stroke prevention presented with abdominal pain. Patient was found to have bleeding and possible mesenteric ischemia and was taken to the operating room and had continued bleeding postoperatively. CRRT was initiated for the removal of any remaining dabigatran, with serum dabigatran levels collected to evaluate removal of dabigatran with CRRT...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27301937/intravenous-thrombolysis-with-recombinant-tissue-type-plasminogen-activator-in-a-stroke-patient-receiving-dabigatran-anticoagulant-after-antagonization-with-idarucizumab
#10
Jörg Berrouschot, Anett Stoll, Theresa Hogh, Christoph Cyrill Eschenfelder
BACKGROUND AND PURPOSE: Therapeutic options for acute ischemic stroke patients presenting on effective anticoagulation are limited. Idarucizumab, a humanized, monoclonal antibody fragment for immediate reversal of dabigatran, may allow this subgroup of orally anticoagulated patients to regain eligibility for thrombolysis. METHODS: We report the first successful acute antagonization of dabigatran by idarucizumab before intravenous thrombolysis with recombinant tissue-type plasminogen activator...
July 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27236361/systemic-thrombolysis-for-ischemic-stroke-after-antagonizing-dabigatran-with-idarucizumab-a-case-report
#11
Niklas Schäfer, Andreas Müller, Ullrich Wüllner
We here describe our experience of systemic thrombolysis therapy for severe ischemic stroke in a patient taking dabigatran for atrial fibrillation. After administration of the monoclonal antibody fragment idarucizumab, the anticoagulative effects of dabigatran were efficiently antagonized and application of alteplase was safe and feasible in our patient. This case report may illustrate a novel treatment option in the neurological emergency setting.
August 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27125504/efficacy-of-prothrombin-complex-concentrates-for-the-emergency-reversal-of-dabigatran-induced-anticoagulation
#12
REVIEW
Oliver Grottke, James Aisenberg, Richard Bernstein, Patrick Goldstein, Menno V Huisman, Dara G Jamieson, Jerrold H Levy, Charles V Pollack, Alex C Spyropoulos, Thorsten Steiner, Gregory J Del Zoppo, John Eikelboom
Dabigatran is effective in decreasing the risk of ischaemic stroke in patients with atrial fibrillation. However, like all anticoagulants, it is associated with a risk of bleeding. In cases of trauma or emergency surgery, emergency reversal of dabigatran-induced anticoagulation may be required. A specific reversal agent for dabigatran, idarucizumab, has been approved by the US Food and Drug Administration. Alternative reversal agents are available, such as prothrombin complex concentrates (PCCs) and activated PCCs (aPCCs)...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27038506/impactful-clinical-trials-of-2015-what-clinicians-need-to-know
#13
Narendra Singh, Milan Gupta
Randomized clinical trials (RCTs) remain the foundation for assessing and introducing evidence-based therapies into cardiovascular (CV) medicine. In 2015, a number of RCTs were reported and published that have great potential to improve CV outcomes and thus to change clinical practice. We highlight the results and implications of major RCTs in the areas of acute coronary syndrome (ACS), interventional cardiology, atrial fibrillation, lipids, heart failure, diabetes, and hypertension. Among the trials we discuss, PEGASUS and DAPT provide guidance regarding the potential benefits and hazards of longer-term dual-antiplatelet therapy after percutaneous coronary intervention (PCI) or myocardial infarction (MI)...
August 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/26971644/-treatment-with-inhibitors-of-new-oral-direct-anticoagulants-in-patients-with-severe-bleedings-or-urgent-surgical-procedures-the-new-dabigatran-antidote-the-place-of-idarucizumab-in-clinical-practice
#14
REVIEW
Zoltán Boda
Only vitamin K antagonists could be applied as oral anticoagulants over the past six decades. Coumarols have narrow therapeutic range, and unpredictable anticoagulant effects are resulted by multiple drug interactions. Therefore, regular routine monitoring of the international normalized ratio is necessary. There are two groups of factor-specific anticoagulants: molecules with anti-FIIa (dabigatran) and anti-FXa (rivaroxaban, apixaban and edoxaban) effect. Author summarizes the most important clinical features of the new oral anticoagulants, their indications and the possibilities of laboratory controls...
March 20, 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/26627486/who-when-and-how-to-reverse-non-vitamin-k-oral-anticoagulants
#15
REVIEW
Konstantinos N Aronis, Elaine M Hylek
Non-vitamin K oral anticoagulants (NOACs) have been a major addition to our therapeutic armamentarium. They are at least as effective as warfarin in the thromboprophylaxis of non-valvular atrial fibrillation and management of thromboembolic disease, with a more favorable safety profile. Their predictable pharmacokinetics and pharmacodynamics allow for a fixed oral dosing without the need for anticoagulation monitoring. A major concern regarding NOACs is the lack of a readily available antidote to reverse their anticoagulation effect in case of life-threatening bleeding or need for emergent surgery...
February 2016: Journal of Thrombosis and Thrombolysis
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