Document Detail


Strategies for urgent reversal of target-specific oral anticoagulants.
MedLine Citation:
PMID:  25485923     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The direct thrombin inhibitor dabigatran and factor Xa inhibitors rivaroxaban and apixaban are US Food and Drug Administration (FDA)-approved target-specific oral anticoagulants (TSOACs) that have emerged onto the market for use in some indications similar to those for warfarin; in addition, edoxaban is seeking FDA approval. Similar indications include reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation for all 3 agents, for the prevention of deep vein thrombosis that may lead to pulmonary embolism in patients undergoing hip or knee surgery for rivaroxaban and apixaban, and for the treatment and prevention of deep vein thrombosis and pulmonary embolism. As anticoagulants, they are all associated with a risk of bleeding, and, unfortunately, there are no approved antidotes for reversal of these agents. A number of small studies in human subjects and in human/animal models exposed to TSOACs have evaluated the use of activated charcoal, hemodialysis for dabigatran, or clotting factor concentrates for their ability to neutralize the anticoagulant effects or reduce drug concentrations of TSOACs. Clotting factor concentrates that have been used include prothrombin complex concentrates and recombinant factor VII. This review examines studies and case reports evaluating these strategies for expedited or emergent reversal of TSOACs.
Authors:
Estella M Davis; Erin M Uhlmeyer; David P Schmidt; Greg L Schardt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hospital practice (1995)     Volume:  42     ISSN:  2154-8331     ISO Abbreviation:  Hosp Pract (1995)     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101268948     Medline TA:  Hosp Pract (1995)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-25     Citation Subset:  AIM; IM    
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