When and How to Use Reversal Agents for Direct Oral Anticoagulants?

Autor: Gómez-Outes A; Division of Pharmacology and Clinical Drug Evaluation, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Campezo 1, 28022, Madrid, Spain. agomezo@aemps.es., Suárez-Gea ML; Division of Pharmacology and Clinical Drug Evaluation, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Campezo 1, 28022, Madrid, Spain., Lecumberri R; Hematology Service, University Clinic of Navarra, Pamplona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
Jazyk: angličtina
Zdroj: Current cardiology reports [Curr Cardiol Rep] 2023 May; Vol. 25 (5), pp. 371-380. Date of Electronic Publication: 2023 Mar 28.
DOI: 10.1007/s11886-023-01858-x
Abstrakt: Purpose of Review: Our objective is to describe currently available reversal agents for direct oral anticoagulants (DOACs), their target population, the available clinical practice recommendations and future directions.
Recent Findings: Specific (idarucizumab for dabigatran and andexanet alfa for direct factor Xa inhibitors) and non-specific (prothrombin complex concentrates) reversal agents are effective in neutralizing the anticoagulant effect of DOACs. New investigational antidotes such as ciraparantag and VMX-C001 offer an alternative to andexanet alfa in reversing the anticoagulant activity of direct oral factor Xa inhibitors, but more clinical data are needed before they could be licensed for use. Specific reversal agents are recommended for use in clinical situations within their licensed indications (i.e.: reversal of DOACs in patients with severe uncontrolled or life-threatening bleeding or in need of emergency surgery or other invasive procedures), while non-specific reversal agents may be used when specific antidotes are not available or indicated.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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