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- Title
Reversal of direct oral anticoagulants.
- Authors
Almegren, Mosaad
- Abstract
Reversal agents for direct oral anticoagulants (DOACs), including factor X inhibitors and direct thrombin inhibitors, are a major concern in clinical practice. After DOACs were introduced and became widely used as an alternative for vitamin K antagonists in the management of venous thromboembolism and nonvalvular atrial fibrillation, the need for effective reversal agents has increased, particularly for life-threatening bleeding episodes related to DOACs or to reverse medication effects during urgent interventions. In the absence of specific reversal agents, prothrombin complex concentrate (PCC) and activated PCC are reasonable options to reverse bleeding associated with DOACs. However, high-quality clinical evidence is lacking. Idarucizumab is the only agent approved by the US Food and Drug Administration to reverse the effects of dabigatran; andexanet alfa and ciraparantag are also under evaluation as reversal agents for DOACs. This review summarizes the current evidence for nonspecific and specific reversal of DOACs.
- Subjects
ANTICOAGULANTS; ANTITHROMBINS; VITAMIN K; THROMBOEMBOLISM; ATRIAL fibrillation; UNITED States. Food &; Drug Administration; DRUG approval
- Publication
Vascular Health & Risk Management, 2017, Vol 13, p287
- ISSN
1176-6344
- Publication type
journal article
- DOI
10.2147/VHRM.S138890