• linkedin
  • Increase Font
  • Sharebar

    Andexanet quickly reverses factor Xa inhibitor activity for DOACs

    Anna D. GarrettBleeding is a complication of treatment with factor Xa inhibitors, but there are no specific agents for the reversal of the effects of these drugs. Andexanet alpha is designed to reverse the anticoagulant effects of factor Xa inhibitors.

    In a recent study, healthy older volunteers were given 5 mg of apixaban twice daily or 20 mg of rivaroxaban daily. For each factor Xa inhibitor, a two-part randomized placebo-controlled study was conducted to evaluate andexanet administered as a bolus or as a bolus plus a 2-hour infusion. The primary outcome was the mean percent change in anti–factor Xa activity.

    Less bleeding with rivaroxaban for venous thromboembolism

    In apixaban-treated participants, anti–factor Xa activity was reduced by 94% among those who received an andexanet bolus, vs. 21% among those who received placebo. Thrombin generation was fully restored in 100% vs. 11% of the participants within 2 to 5 minutes. Among the rivaroxaban-treated participants, anti–factor Xa activity was reduced by 92% among those who received an andexanet bolus vs. 18% among those who received placebo. Thrombin generation was fully restored in 96% vs. 7% of the participants. These effects were sustained when andexanet was administered as a bolus plus an infusion. No serious adverse or thrombotic events were reported.

    The manufacturer is pursuing an accelerated approval pathway with the FDA.

    Siegal DM, Curnutte JT, Connolly SJ et al. Andexanet alfa for the reversal of factor Xa inhibitor activity. NEJM 2015. Published online before print Nov 11,2015:DOI: 10.1056/NEJMoa1510991.

    Anna D. Garrett, PharmD, BCPS
    Anna D. Garrett is a clinical pharmacist and president of Dr. Anna Garrett (www.drannagarrett.com). Her mission is to help women in ...

    0 Comments

    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available
    Slideshows
    Small Doses: The Weekly News You Need to Know
    Small Doses: The Weekly News You ...

    Small doses is a weekly slideshow of the news you may have missed, made just for you and your busy lifestyle.

    25 Cities With The Lowest Pharmacist ...
    Strange, offbeat, and obscure ...