Andexxa—An Antidote for Apixaban and Rivaroxaban

doi:10.1001/jama.2018.9257

Cited by 18 publications

(2 citation statements)

References 8 publications

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“…However, the American guidelines recommend warfarin treatment for this group of patients. Recently, a meta-analysis showed that among patients with AF and mild-to-moderate renal dysfunction, subgroup analyses from trials and observational studies appear to support the net benefit of warfarin over no anticoagulation [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Tamponade Risk Associated With Anticoagulation for Atrial Fibrillation in Dialysis-Associated Pericarditis: A Case Report

Abu-Abaa¹,

Hassan²,

Mousa³

et al. 2023

Cureus

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Heparin is a preferred initial anticoagulant in patients with new-onset atrial fibrillation (AF). Despite continuous debate about the risk, there has been a concern about heparin-induced hemorrhagic pericarditis and cardiac tamponade. We present a case of a new onset atrial fibrillation (AF) in a patient with renal impairment and evidence of pericardial effusion complicated by hemopericardium development after starting anticoagulation. Although the risk of hemorrhagic conversion of uremic pericarditis induced by heparin in ESRD patients with new onset AF was suggested in the literature, this case raises the possibility of a similar complication in dialysis-associated pericarditis. Therefore, we aim to heighten alertness regarding this potential complication of a commonly used medication in clinical practice. We also aim to review the current anticoagulation recommendations in this setting.

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Section: Discussionmentioning

confidence: 99%

Cardiac Tamponade Risk Associated With Anticoagulation for Atrial Fibrillation in Dialysis-Associated Pericarditis: A Case Report

Abu-Abaa¹,

Hassan²,

Mousa³

et al. 2023

Cureus

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“…Recently the availability of andexanet alfa to reverse the effects of apixaban and rivaroxaban has added a potential solution to the management of patients presenting with bleeding complications such as hemorrhagic pericardial effusions. This agent has been shown to rapidly reverse the anticoagulant effects of direct and indirect (enoxaparin and fondaparinux) factor Xa inhibitors, although no phase three clinical trials or head-to-head trials with usual care are currently available [18].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Hemorrhagic Pericardial and Pleural Effusion in a Patient Receiving Apixaban

et al. 2019

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Direct oral anticoagulants (DOACs) are used for many conditions where anticoagulation is needed such as non-valvular atrial fibrillation, deep vein thrombosis (DVT) and pulmonary embolism (PE). These novel agents have become popular since they do not require monitoring of therapeutic levels and there is a lower risk of certain bleeding complications when compared to warfarin. However, the efficacy and side effect profile of these agents have not been widely studied in certain patient cohorts, namely cancer patients and patients on immunomodulators or hormone analogs. We present a case of a patient with a history of malignancy and autoimmune disease who developed pericardial and pleural effusions shortly after initiating apixaban for treatment of a PE. In addition, we aim to increase awareness of the role that the newly available reversal agents for anticoagulants would offer in the acute management of hemorrhagic pericardial and pleural effusions caused by DOACs in patients with and without malignancy.

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