Why the study?
With shifts from warfarin to direct oral anticoagulants causing substantial bleeding-related emergency visits, targeted reversal agents are essential for managing life-threatening bleeds.
Provides a comprehensive summary of currently available and pipeline target-specific anticoagulation reversal agents for the management of life-threatening bleeds.
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Supports stocking targeted reversal agents for life-threatening DOAC bleeds; leaves open strategies for agents still lacking specific antidotes.
Bleeding related to direct oral anticoagulants accounts for nearly half of emergency department visits annually and until recently there were no reversal antidotes available. As there continues to be a shift in prescribing practices away from warfarin, it is essential to have these reversal agents readily available for the treatment of life-threatening bleeds associated with these anticoagulants. In addition, for agents that continue to lack a targeted reversal agent (eg, low-molecular-weight heparin, antiplatelets, and new antithrombotics), it is imperative that research continues to evaluate improved reversal strategies. This review focuses on target-specific anticoagulation reversal agents currently available in the United States (protamine, idarucizumab, and andexanet alfa) and summarizes agents that are in the pipeline for these anticoagulants and antiplatelets.
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A 2022 study studied this question.
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