Beriplex achieved immediate reversal of the INR and vitamin K-dependent clotting factors in virtually all 42 patients requiring rapid warfarin reversal, with one thrombotic event at 7 days.
Observational (n=42)
Does prothrombin complex concentrate rapidly reverse oral anticoagulation with warfarin in patients requiring immediate reversal?
Prothrombin complex concentrate is effective in rapidly reversing the anticoagulant effects of warfarin without inducing coagulation activation.
Beriplex, a prothrombin complex concentrate (PCC), was administered to 42 patients requiring immediate reversal of their oral anticoagulant therapy. The dose administered was determined using the pretreatment International Normalized Ratio (INR). Blood samples were obtained before treatment and at 20, 60 and 120 min after treatment. The following investigations were performed on all samples - INR, clotting factors II, VII, IX and X, coagulation inhibitors protein C (PC) and antithrombin (AT), and other markers of disseminated intravascular coagulation, plasma fibrinogen, D-dimer and platelet count. Immediate reversal of the INR, the vitamin K-dependent clotting factors and PC was achieved in virtually all patients. Reduced AT levels were present in 18 patients before treatment. Further slight AT reductions occurred in four patients, but other associated abnormalities of haemostasis were observed in only one of the four patients. One patient with severe peripheral vascular disease, sepsis and renal and cardiac failure died of a thrombotic stroke following leg amputation, 48 h after receiving Beriplex. No other arterial and no venous thromboembolic events occurred within 7 d of treatment. Beriplex is effective in rapidly reversing the anticoagulant effects of warfarin, including PC deficiency, without inducing coagulation activation. Caution should continue to be exercised in the use of these products in patients with disseminated intravascular coagulation, sepsis or liver disease.
Preston et al. (Fri,) conducted a observational in Requiring immediate reversal of oral anticoagulant therapy (n=42). Beriplex (prothrombin complex concentrate) was evaluated on Immediate reversal of the INR, vitamin K-dependent clotting factors and protein C. Beriplex achieved immediate reversal of the INR and vitamin K-dependent clotting factors in virtually all 42 patients requiring rapid warfarin reversal, with one thrombotic event at 7 days.
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