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




Saturday, May 7, 2016

Reversal of NOAC's and more

EMOttawa - May 5, 2016
"We have seen a large surge of the utilization of New Oral Anticoagulants (NOAC's) in the past few years, as such, it has been a novel challenge when these patients present to the Emergency Department (ED) with life threatening bleeding. Dr. Michael Ho looks to discuss treatment options, and future options in these patients...
Bottom Lines
  1. NOACs are safer than warfarin, and are here to stay.
  2. Reversal of anticoagulation has not convincingly been shown to improve clinical outcomes, even when it is safe and effective.
  3. Reversal agents for NOACs are coming, whether we want them or not. Their biochemical results are robust, but their clinical benefits are not yet proven. We will likely be forced to use these drugs without evidence of clinical benefit for the time being.
  4. Idarucizumab (Praxbind) will likely soon be available in Canadian EDs, and they will be indicated for life threatening bleeding and emergency procedures/surgery.
  5. Drugs to watch for: 
    1. Andexant alfa (Xa inhibitor reversal)
    2. Ciraparantag (NOAC and heparin reversal)"