The mode of action of sugammadex on coagulation

Autor: Ria H. Laterveer, Annelieke C. Kruithof, Cornelis Kluft, Matthijs Moerland, Pieter-Jan de Kam, Jacobus Burggraaf
Rok vydání: 2021
Předmět:
Zdroj: Int. Journal of Clinical Pharmacology and Therapeutics. 59:89-98
ISSN: 0946-1965
DOI: 10.5414/cp203858
Popis: Objective To explore the mode of action (MoA) by which sugammadex interferes with coagulation. Materials and methods The effect of sugammadex on various steps in the coagulation cascade including thrombin generation, factor Xa activity, and factor Xa generation was explored in human plasma. Results Sugammadex did not affect a conventional thrombin generation test (TGT), while it prolongs activated partial thromboplastin time (APTT) and prothrombin time (PT). However, a customized TGT with PT reagent revealed sugammadex effects. In addition, sugammadex prolonged a one-step prothrombinase-induced clotting time (PiCT) using human factor Xa. Furthermore, sugammadex interfered with factor Xa generation induced by an intrinsic and not by an extrinsic activator, nor by Russell's viper venom factor X (RVV-X). Conclusion Adapted, rather than standard, experiments show that sugammadex is likely to decrease factor Xa activity in the common pathway and activation of factor X specifically in the intrinsic pathway.
Databáze: OpenAIRE