Key result
Andexanet alfa restored non-tissue factor-initiated thrombin generation to pre-anticoagulant levels in 100% of subjects treated with apixaban or rivaroxaban, compared to placebo.
Why the study?
Does andexanet alfa restore tissue factor and non-tissue factor-initiated thrombin generation in healthy older volunteers treated with apixaban or rivaroxaban?
RCT (n=70)
Does andexanet alfa restore tissue factor and non-tissue factor-initiated thrombin generation in healthy older volunteers treated with apixaban or rivaroxaban?
Andexanet alfa effectively reverses the anticoagulant activity of apixaban and rivaroxaban by restoring both tissue factor and non-tissue factor-initiated thrombin generation.
May support andexanet alfa for apixaban/rivaroxaban reversal; leaves open clinical efficacy in bleeding patients.
Andexanet alfa is a modified factor Xa (FXa) drug designed to bind and sequester FXa inhibitors and thus reverse anticoagulation. The oral presentation reviewed in this article, presented by Dr Genmin Lu at the European Society of Cardiology (ESC) Congress 2018, provides new insights into the effect of the interaction between andexanet alfa and tissue factor (TF) pathway inhibitors on the restoration of thrombin generation (TG) in the TF (extrinsic) and non-TF (intrinsic) coagulation pathways.
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Lu et al. (2018) conducted an RCT in Healthy volunteers anticoagulated with apixaban or rivaroxaban (n=70). Andexanet alfa vs. Placebo was evaluated on Restoration of non-tissue factor-initiated thrombin generation to pre-anticoagulant levels (apixaban cohort) (p=0.0003). Andexanet alfa restored non-tissue factor-initiated thrombin generation to pre-anticoagulant levels in 100% of subjects treated with apixaban or rivaroxaban, compared to placebo.
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