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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com


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viernes, 5 de febrero de 2016

Andexanet Alfa

The Bottom Line - Feb 5 2016
Siegal DM. N Engl J Med 2015 - doi: 10.1056/NEJMoa1510991
Clinical Question
  • In healthy adults taking either apixaban (ANNEXA-A) or rivaroxaban (ANNEXA-R) does andexanet alfa compared to placebo normalise anticoagulation?
The Bottom Line
  • Both ANNEXA-A and ANNEXA-R show impressive reversal of anti-factor Xa activity by andexanet. 
  • It should however be made clear that safety data of any meaning will only come from larger phase 3b-4 studies, which are in progress (Clinical trials.gov NCT02329327). Caution must be exercised with any new drug particularly if the results are used to guide emergency reversal of patients anti-coagulated with factor Xa inhibitors, which of course is the intended aim of such agents due to the myriad of factors that affect bleeding tendency in the acute setting.