Current Data on the Role of Specific Antidotes for the Reversal of Non-Vitamin K Oral Anticoagulant Action
Keywords:
non-vitamin-K anticoagulants, oral anticoagulants, dabigatran, rivaroxaban, apixaban, antidotes, idarucizumab, andexanet alfa, aripazineAbstract
The increasing use of the non-vitamin K oral anticoagulants during the recent years was associated with the need of development of targeted agents that could reverse the anticoagulative activity in cases of severe bleeding episodes or urgent high risk operations. Thus, several reversal agents are currently in development and the early results seem promising. Idarucizumab is a monoclonal antibody that can immediately and specifically reverse dabigatran action. Andexanet alfa is a recombinant modified factor Xa that can bind and reverse factor Xa inhibitors, including rivaroxaban, apixaban and edoxaban, and low molecular weight heparin. Aripazine is a universal reversal agent small molecule that can reverse the action of factor Xa inhibitors, unfractionated and low molecular weight heparin and possibly dabigatran. Currently, only idarucizumab has received approval from the United States Food and drug Administration for the reversal of the dabigatran. Rhythmos 2016;11(3):70-72.
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