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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Res+Pract+Thromb+Haemost
2018 ; 2
(2
): 251-265
Nephropedia Template TP
gab.com Text
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English Wikipedia
Pharmacological reversal of the direct oral anticoagulants-A comprehensive review
of the literature
#MMPMID30046727
Shaw JR
; Siegal DM
Res Pract Thromb Haemost
2018[Apr]; 2
(2
): 251-265
PMID30046727
show ga
The direct oral anticoagulants (DOACs) are used for stroke prevention in atrial
fibrillation (SPAF) and the prevention and treatment of venous thromboembolic
disease (VTE). Although DOAC-associated bleeding events are less frequent as
compared to vitamin K antagonists, there is significant concern surrounding
physicians' ability to evaluate and manage DOAC-associated bleeding when it does
occur. Idarucizumab is a specific reversal agent for dabigatran and is the agent
of choice for dabigatran reversal in the setting of major bleeding or urgent
surgery/procedures. There are no commercially available specific reversal agents
for the direct Xa inhibitors. Although they have not been rigorously studied in
DOAC-treated patients requiring urgent anticoagulant reversal, limited evidence
from in vitro studies, animal bleeding models, human volunteer studies (in vivo
and in vitro) and case series suggest that coagulation factor replacement with
prothrombin complex concentrate (PCC) and activated PCC (FEIBA) may contribute to
hemostasis. However, the safety and efficacy of these agents and the optimal
dosing strategies remain uncertain.