Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage

To the Editor: In the ANNEXA-I trial (Trial of Andexanet Alfa in Intracranial Hemorrhage Patients Receiving an Oral FXa Inhibitor) conducted by Connolly et al. (May 16/23 issue), 1 investigators evaluated the use of andexanet alfa in cerebral hemorrhage associated with factor Xa use, which is currently the subject of debate, given that guidelines are contradictory. 2,3 We are concerned about the potentially unbalanced data presentation. In contrast to the andexanet group, in which 98.2% of the patients received the trial drug, only 85.5% of the patients in the usual-care group received prothrombin complex concentrate. This situation disadvantages the control group. If . . .