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- Title
Effect of low- versus high-dose 4-factor prothrombin complex concentrate in factor Xa inhibitor–associated bleeding: A qualitative systematic review.
- Authors
Phillips, Anna; Bradley, Colby; Cash, Julie; Sangiovanni, Ryan; Wingerson, Charles
- Abstract
Purpose The purpose of this review is to evaluate current literature on the treatment of factor Xa inhibitor–associated bleeds with 4-factor prothrombin complex concentrate (4F-PCC), with a focus on the effect of low versus high dosing of 4F-PCC on hemostatic efficacy and safety outcomes. Summary A search of PubMed and EBSCOhost was performed to identify studies evaluating patients with a factor Xa inhibitor–bleed treated with 4F-PCC at either low or high doses. Studies of patients receiving alternative reversal agents such as fresh frozen plasma and andexanet alfa or where no comparator group was evaluated were excluded from the analysis. To assess the effect of these 4F-PCC dosing strategies, the primary outcome of interest was hemostatic efficacy. Four studies meeting inclusion criteria were included in this review. In each of the included studies, similar rates of hemostatic efficacy, hospital mortality, and venous thromboembolism were observed in the low- and high-dose cohorts. Conclusion These results suggest low- and high-dose 4F-PCC may confer similar clinical effectiveness and safety; however, these findings should be evaluated and confirmed with future prospective studies.
- Subjects
ANTICOAGULANTS; PATIENT safety; QUALITATIVE research; TREATMENT effectiveness; DESCRIPTIVE statistics; BLOOD coagulation factors; DOSE-effect relationship in pharmacology; SYSTEMATIC reviews; MEDLINE; DRUG efficacy; SURGICAL hemostasis; ONLINE information services; HEMORRHAGE; EVALUATION
- Publication
American Journal of Health-System Pharmacy, 2024, Vol 81, Issue 11, pe274
- ISSN
1079-2082
- Publication type
Article
- DOI
10.1093/ajhp/zxae009