Specific antidotes against direct oral anticoagulants: A comprehensive review of clinical trials data

Tummala, Ramyashree; Kavtaradze, Ana; Gupta, Anjan; Ghosh, Raktim

doi:10.1016/j.ijcard.2016.03.056

Cited by 75 publications

(45 citation statements)

References 74 publications

(10 reference statements)

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“…Idarucizumab, a humanized, monoclonal antibody fragment that binds both free and thrombin-bound dabigatran, can be use in dose of IV 5 g for immediate reversal of dabigatran. Their safety and efficacy were subsequently established in phase III study (Tummala et al, 2016). It is approved under accelerated approval in the USA and in the European Union at the end of 2015 for patients in use of dabigatran that need emergency surgery or urgent procedures and in life-threatening or uncontrolled bleeding (EMA, 2016;FDA, 2016).…”

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

“…Until the present time, a specific antidote for rivaroxaban was not approved. Andexanet alpha, a recombinant human factor Xa analogue that competes for the factor Xa inhibitors with factor Xa, and ciraparantag (Aripazine), a synthetic molecule that seems to have more widespread antagonistic effects, are under investigation Heidbuchel et al, 2016;Tummala et al, 2016).…”

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

“…The drug acts within 2 to 5 min after infusion (bolus and maintained for 2 h), and has a half-life of approximately 45 min (Reiffel et al, 2016). However, this antidote is still under investigation Heidbuchel et al, 2016;Tummala et al 2016).…”

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

“…The oral 60 mg dose produces a 2-fold increase in prothrombin time (Ogata et al, 2010). The antidote Andexanet alpha is still under investigation Tummala et al, 2016). The pharmacodynamic and pharmacokinetic profiles of NOACs are summarized in Table 1.…”

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

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Pharmacological profile of non-vitamin K antagonist oral anticoagulants

Silva¹

2017

Afr. J. Pharm. Pharmacol.

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female patients, oral anticoagulants are recommended, and considering shared decision between doctor and patient. However, they are contraindicated in patients with mechanical prosthetic valve and in patients with moderate-to-severe mitral stenosis and atrial fibrillation. They have also been approved for prevention and treatment of deep vein thrombosis and pulmonary embolism. Dabigatran, a direct thrombin inhibitor, was the first to be approved, followed by the factor Xa inhibitors, rivaroxaban, apixaban, and recently, in 2015, edoxaban. They have advantages such as the use of fixed-dose, with infrequent drug interaction, rapid onset of action and do not require monitoring of their anticoagulant action. Nonetheless, they have different half-lives, the need for dose adjustment according to renal function, weight and age of the patient. Its use in pregnant women and children or adolescents is not well established. There are also peculiarities about the risks of bleeding, effects on coagulation tests and specific antidotes. Through this review we discuss the pharmacokinetics and pharmacodynamics characteristics of direct oral anticoagulants, its indications, interactions and contraindications. Analysis of its efficacy, safety and risk-benefit ratio will also be addressed.

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Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

Section: Laboratory Monitoring and Antidotementioning

confidence: 99%

See 2 more Smart Citations

Pharmacological profile of non-vitamin K antagonist oral anticoagulants

Silva¹

2017

Afr. J. Pharm. Pharmacol.

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“…It is a recombinant modified human factor Xa decoy protein that can bind Xa inhibitors with high affinity. Adexanet is currently being evaluated in ANNEXA-4, a phase 4 trial, with its use as an antidote in patients with severe bleeding (41). Aripazine (PER977) has been developed as a reversal agent for ultrafractionated heparin and low-molecular weight heparin, but also appears to effectively bind edoxaban, rivaroxaban, apixaban, and dabigatran (37).…”

Section: Reversal Agentsmentioning

confidence: 99%

Use of novel oral anticoagulant agents in venous thromboembolism

Madan¹,

Shah²,

Dale³

et al. 2016

Cardiovasc. Diagn. Ther.

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New oral anticoagulants (NOAC) serve as alternatives for patients currently using warfarin for the prevention and treatment of venous thromboembolic (VTE) disease. This article provides a brief summary of the clinical use of these drugs as well as a review of the landmark clinical trials which evaluated described their safety and efficacy. As more data becomes available, a fundamental understanding of these medications will be vital to cardiovascular practitioners managing patients with VTE.

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Novel Antithrombotic Drugs and Intraocular Bleeding

Caldeira

2018

JAMA Ophthalmol

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Specific antidotes against direct oral anticoagulants: A comprehensive review of clinical trials data

Cited by 75 publications

References 74 publications

Pharmacological profile of non-vitamin K antagonist oral anticoagulants

Pharmacological profile of non-vitamin K antagonist oral anticoagulants

Use of novel oral anticoagulant agents in venous thromboembolism

Novel Antithrombotic Drugs and Intraocular Bleeding

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