Andexanet alfa for reversal of factor Xa inhibitors: a critical review of the evidence.
Future Cardiol
; 15(6): 395-404, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31668083
ABSTRACT
Direct oral anticoagulants are associated with lower rates of bleeding than vitamin K antagonists, but life-threatening bleeding still occurs. Andexanet alfa is a catalytically inactive recombinant modified human factor Xa molecule that reverses the anticoagulant effect of direct and indirect acting factor Xa inhibitors. In the ANNEXA-4 study, treatment with andexanet was associated with a 92% reduction in median anti-Xa activity levels and excellent or good hemostasis in 82% of patients presenting with serious bleeding while receiving apixaban or rivaroxaban. In this review, we discuss the burden of bleeding in anticoagulated patients and the need for reversal agents, review the mechanism of action of andexanet and critically evaluate the evidence for its efficacy and safety.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Coagulação Sanguínea
/
Proteínas Recombinantes
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Fator Xa
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Inibidores do Fator Xa
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Hemorragia
Limite:
Humans
Idioma:
En
Revista:
Future Cardiol
Ano de publicação:
2019
Tipo de documento:
Article