Arrhythmia & Electrophysiology Review - A New Era for NOAC Antidotes

There are no clear interactions with food, and no need for frequent laboratory monitoring and dose adjustments1–3 Their main problems so far have been the lack of antidotes and specific assays to measure anticoagulant effect, and considerably higher cost than warfarin4 It is, therefore, of major cli...

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Bibliographic Details
Published in:Arrhythmia & electrophysiology review 2015-05, Vol.4 (1), p.8-8
Main Author: Katritsis, Demosthenes
Format: Article
Language:English
Subjects:
Anticoagulants
Cardiac arrhythmia
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Summary:There are no clear interactions with food, and no need for frequent laboratory monitoring and dose adjustments1–3 Their main problems so far have been the lack of antidotes and specific assays to measure anticoagulant effect, and considerably higher cost than warfarin4 It is, therefore, of major clinical importance to see specific antidotes emerging in phase 1 and 2 trials. Idarucizumab, a fully humanised antibody fragment, or Fab, is investigated as a specific antidote of dabigatran, and also reversed its effects and, unlike PCCs, was not associated with over-correction of thrombin generation7 Four-factor PCCs are also general antidotes for Xa inhibitors such as apixaban, rivaroxaban and endoxaban6 Specific antidotes such as aripazine (PER977, 100–200 mg), a synthetic molecule that binds specifically to unfractionated heparin and low-molecular-weight heparin, and the recombinant factor Xa andexanet have been successfully used for edoxaban and rivaroxaban. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: A meta-analysis of randomised trials.
ISSN:2050-3369
2050-3377
2050-3377
DOI:10.15420/aer.2015.4.1.8