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2016 ; 9
(3
): 176-80
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Reversibility of Apixaban Anticoagulation with a Four-Factor Prothrombin Complex
Concentrate in Healthy Volunteers
#MMPMID27170068
Nagalla S
; Thomson L
; Oppong Y
; Bachman B
; Chervoneva I
; Kraft WK
Clin Transl Sci
2016[Jun]; 9
(3
): 176-80
PMID27170068
show ga
It was hypothesized that the four-factor prothrombin complex concentrate (4F-PCC)
Kcentra 25 unit/kg would reverse impairment of thrombin generation in healthy
volunteers dosed with apixaban to steady state. In this randomized, two-period
crossover, assessor-blinded trial, 12 healthy subjects received 5 mg apixaban
every 12 h. Three h after the fifth dose, four-factor prothrombin complex
concentrate (4F-PCC) 25 unit/kg or saline were infused. Serial blood samples were
assessed for thrombin generation using PPP-reagent and PPP-reagent low, anti-Xa,
PT, and PTT assays. Geometric mean ratio was calculated at 30 min postinfusion,
and at 24, 48, and 72 h. Peak thrombin generation was 76% higher at 30 min
postinfusion with 4F-PCC (p = 0.025). The difference declined to 24% at 24 h and
resolved by 48 h. Other thrombin generation parameters were also partially
normalized. There was no difference between 4F-PCC and saline in anti-Xa
assessment at 30 min or later time points.