An Update on the Reversal of Non-Vitamin K Antagonist Oral Anticoagulants.

An Update on the Reversal of Non-Vitamin K Antagonist Oral Anticoagulants. Adv Hematol. 2020;2020:7636104 Authors: Mujer MTP, Rai MP, Atti V, Dimaandal IL, Chan AS, Shrotriya S, Gundabolu K, Dhakal P Abstract Non-vitamin K antagonist oral anticoagulants (NOACs) include thrombin inhibitor dabigatran and coagulation factor Xa inhibitors rivaroxaban, apixaban, edoxaban, and betrixaban. NOACs have several benefits over warfarin, including faster time to the achieve effect, rapid onset of action, fewer documented food and drug interactions, lack of need for routine INR monitoring, and improved patient satisfaction. Local hemostatic measures, supportive care, and withholding the next NOAC dose are usually sufficient to achieve hemostasis among patients presenting with minor bleeding. The administration of reversal agents should be considered in patients on NOAC's with major bleeding manifestations (life-threatening bleeding, or major uncontrolled bleeding), or those who require rapid anticoagulant reversal for an emergent surgical procedure. The Food and Drug Administration (FDA) has approved two reversal agents for NOACs: idarucizumab for dabigatran and andexanet alfa for apixaban and rivaroxaban. The American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) have released an updated guideline for the management of patients with atrial fibrillation that provides indications for the use of these ...
Source: Advances in Hematology - Category: Hematology Tags: Adv Hematol Source Type: research