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An antidote for new oral anticoagulants (NOACs)?

Andexanet.

The direct factor Xa inhibitors apixaban, rivaroxaban, and edoxaban (NOACs) are indicated for prevention of stroke in patients with non-valvar atrial fibrillation (AF).

There has Been no specific antidote to reverse the anticoagulant effects of these agents. They tested the effects of andexanet, which has been designed to neutralise the anticoagulant effects of direct and indirect factor Xa inhibitors. It seems to work, in healthy volunteers! I bet it will be very expensive when it comes out. But, bleeding needing reversal is thankfully very rare.

Siegal DM, Curnutte JT, Connolly SJ, et al. Andexanet alfa for the reversal of factor Xa inhibitor activity. NEJM2015; doi:10.1056/NEJMoa1510991.

Dr Iqbal Malik

Posted on 08 December 2015
Author: LCC
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