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Am J Med. 2016 Nov;129(11S):S80-S88. doi: 10.1016/j.amjmed.2016.06.009. Epub 2016 Aug 27.

Preclinical and Clinical Data for Factor Xa and "Universal" Reversal Agents.

Author information

1
Departments of Neurology and Surgery and Perioperative Care, Seton Dell Medical School Stroke Institute Austin, Tex.
2
Division of Hospital Medicine, Henry Ford Hospital, Detroit, MI. Electronic address: skaatz1@hfhs.org.

Abstract

Oral Factor Xa (FXa) inhibitors, a growing class of direct-acting anticoagulants, are frequently used to prevent stroke and systemic embolism in patients with atrial fibrillation and to prevent and treat venous thromboembolism. These drugs reduce the risk of clotting at the expense of increasing the risk of bleeding, and currently they have no specific reversal agent. However, andexanet alfa, a recombinant modified FXa decoy molecule, is in a late-phase clinical trial in bleeding patients, and ciraparantag, a small molecule that appears to reverse many anticoagulants including the FXa inhibitors, is in development. This review summarizes the published data to date on both drugs, which have the potential to change the management approach to patients with FXa inhibitor-associated major hemorrhage.

KEYWORDS:

Andexanet alfa; Anticoagulant; Aripazine; Ciraparantag; PER977; PRT064445; PRT4445; Reversal agent

PMID:
27575436
PMCID:
PMC5568764
DOI:
10.1016/j.amjmed.2016.06.009
[Indexed for MEDLINE]
Free PMC Article

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