Title |
Reversing factor Xa inhibitors – clinical utility of andexanet alfa
|
---|---|
Published in |
Journal of Blood Medicine, September 2017
|
DOI | 10.2147/jbm.s121550 |
Pubmed ID | |
Authors |
Scott Kaatz, Hardik Bhansali, Joseph Gibbs, Robert Lavender, Charles E Mahan, David G Paje |
Abstract |
Approximately half of patients started on an oral anticoagulant in the USA now receive one of the newer direct oral anticoagulants (DOACs). Although there is an approved reversal agent for the direct thrombin inhibitor dabigatran, a specific reversal agent for the anti-factor Xa (FXa) DOACs has yet to be licensed. Unlike the strategy to reverse the only oral direct thrombin inhibitor with idarucizumab, which is a humanized monoclonal antibody fragment, a different approach is necessary to design a single agent that can reverse multiple anti-FXa medications. Andexanet alfa is a FXa decoy designed to reverse all anticoagulants that act through this part of the coagulation cascade including anti-FXa DOACs, such as apixaban, edoxaban and rivaroxaban, and indirect FXa inhibitors such as low-molecular-weight heparins. This narrative reviews the development of andexanet alfa and explores its basic science, pharmacokinetics/pharmacodynamics, animal models, and human studies. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 67% |
Unknown | 1 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 3 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 74 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 11 | 15% |
Other | 10 | 14% |
Student > Doctoral Student | 6 | 8% |
Student > Ph. D. Student | 5 | 7% |
Student > Master | 4 | 5% |
Other | 12 | 16% |
Unknown | 26 | 35% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 25 | 34% |
Pharmacology, Toxicology and Pharmaceutical Science | 5 | 7% |
Biochemistry, Genetics and Molecular Biology | 3 | 4% |
Agricultural and Biological Sciences | 2 | 3% |
Neuroscience | 2 | 3% |
Other | 9 | 12% |
Unknown | 28 | 38% |